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遗传性血栓形成倾向患者复发性流产的免疫危险因素

Immunological Risk Factors in Recurrent Pregnancy Loss in Patients With Hereditary Thrombophilia.

作者信息

Kirovakov Zlatko, Konova Emiliana, Hinkova Nadezhda, Markova Stefani, Penchev Plamen

机构信息

Department of Midwifery Care, Faculty of Health Care, Medical University - Pleven, Pleven, BGR.

Department of Obstetrics and Gynecology, University Hospital for Active Treatment - Burgas, Burgas, BGR.

出版信息

Cureus. 2024 Mar 20;16(3):e56555. doi: 10.7759/cureus.56555. eCollection 2024 Mar.

Abstract

BACKGROUND

Recurrent pregnancy loss (RPL) is a complicated reproductive disorder with underlying genetic and immunological causes. RPL may be influenced by hereditary thrombophilia, a class of blood clotting-related genetic abnormalities, via the vascular and immune systems. This study examines the immunological characteristics that hereditary thrombophilia patients have in common with RPL.

METHODS

A prospective cohort study included 300 patients split into two groups: a control group without hereditary thrombophilia and a group with the condition. Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ) levels were measured, along with demographic specifics, antiphospholipid antibodies, natural killer (NK) cell counts, and other cytokines. Group differences were found using statistical analysis.

RESULTS

Antiphospholipid antibodies were significantly more common in the thrombophilia group (42% testing positive, p=0.001) compared to the control group (12% testing positive), despite demographic factors being similar between groups (p=0.372 and p=0.093). When body mass index (BMI) was taken into account, the study found a statistically significant difference (p=0.046), with the thrombophilia group having a higher mean BMI (26.3 kg/m, standard deviation (SD): 2.8) than the control group (24.7 kg/m, SD: 3.1). IL-6 (14.8 pg/mL, SD: 3.2, p=0.029) were higher than the control group (12.4 pg/mL, SD: 2.1), and TNF-α levels were higher in the thrombophilia group (10.5 pg/mL, SD: 2.0, p=0.012) compared to the control group (8.9 pg/mL, SD: 1.5), but NK cell counts did not differ significantly (p=0.213).

CONCLUSION

This study emphasizes the role of elevated pro-inflammatory cytokines (IL-6 and TNF-α) and antiphospholipid antibodies in RPL among people with hereditary thrombophilia. In this population, early detection and immunomodulatory interventions may improve pregnancy outcomes. To fully comprehend these mechanisms and create customized treatments, collaborative research is required.

摘要

背景

复发性流产(RPL)是一种复杂的生殖系统疾病,其潜在病因包括遗传和免疫因素。遗传性易栓症是一类与血液凝固相关的基因异常,可能通过血管和免疫系统影响复发性流产。本研究旨在探讨遗传性易栓症患者与复发性流产患者共有的免疫特征。

方法

一项前瞻性队列研究纳入了300名患者,分为两组:一组为无遗传性易栓症的对照组,另一组为患有遗传性易栓症的患者组。检测了白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和干扰素-γ(IFN-γ)水平,以及人口统计学特征、抗磷脂抗体、自然杀伤(NK)细胞计数和其他细胞因子。通过统计分析发现组间差异。

结果

尽管两组间人口统计学因素相似(p = 0.372和p = 0.093),但遗传性易栓症组抗磷脂抗体阳性率(42%)显著高于对照组(12%)(p = 0.001)。考虑体重指数(BMI)时,研究发现两组间存在统计学显著差异(p = 0.046),遗传性易栓症组的平均BMI(26.3 kg/m,标准差(SD):2.8)高于对照组(24.7 kg/m,SD:3.1)。遗传性易栓症组的IL-6水平(14.8 pg/mL,SD:3.2,p = 0.029)高于对照组(12.4 pg/mL,SD:2.1),TNF-α水平也高于对照组(10.5 pg/mL,SD:2.0,p = 0.012)(对照组为8.9 pg/mL,SD:1.5),但NK细胞计数无显著差异(p = 0.213)。

结论

本研究强调了促炎细胞因子(IL-6和TNF-α)升高以及抗磷脂抗体在遗传性易栓症患者复发性流产中的作用。对于这一人群,早期检测和免疫调节干预可能改善妊娠结局。为了全面理解这些机制并制定个性化治疗方案,需要开展合作研究。

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