Abramov Y, Schenker J G, Lewin A, Friedler S, Nisman B, Barak V
Department of Obstetrics and Gynecology, Hebrew University Hadassah Medical Center, Ein-Kerem, Jerusalem, Israel.
Hum Reprod. 1996 Jul;11(7):1381-6. doi: 10.1093/oxfordjournals.humrep.a019404.
The objective of this study was to follow the kinetics of four inflammatory cytokines in the plasma and ascitic fluid of seven patients who developed severe ovarian hyperstimulation syndrome (OHSS) after induction of ovulation for in-vitro fertilization. Blood samples were obtained from these patients at three different times: upon hospitalization; when significant clinical improvement was evident; and after complete resolution. Samples were analysed for interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor alpha (TNF-alpha). Ascitic fluid was obtained by therapeutic paracentesis from all study patients during the active phase and analysed for these cytokines. Two control groups were available: the first included 15 women undergoing controlled ovarian stimulation for in-vitro fertilization without developing OHSS, while the second consisted of 25 healthy women not undergoing ovulation induction or any other medical treatment. High concentrations of IL-1, IL-6 and TNF-alpha were detected in all individuals upon admission for severe OHSS. Concentrations dropped significantly along with clinical improvement, reaching normal values after complete resolution. A statistically significant correlation was found between plasma cytokine concentrations and certain biological characteristics of the syndrome such as leukocytosis, increased haematocrit, and elevated plasma 17-beta-oestradiol concentrations. Ascitic fluid obtained from the study patients contained high IL-6 and IL-8 concentrations, while other cytokines were unaltered. These results suggest close association between inflammatory cytokines and the pathophysiology of the ovarian hyperstimulation syndrome.
本研究的目的是追踪7例因体外受精诱导排卵后发生严重卵巢过度刺激综合征（OHSS）患者血浆和腹水中4种炎性细胞因子的动力学变化。在3个不同时间点采集这些患者的血样：入院时；临床有明显改善时；完全康复后。对样本进行白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和肿瘤坏死因子α（TNF-α）分析。在疾病活动期，通过治疗性腹腔穿刺术从所有研究患者中获取腹水，并对这些细胞因子进行分析。有两个对照组：第一组包括15名接受体外受精控制性卵巢刺激但未发生OHSS的女性，第二组由25名未接受排卵诱导或任何其他治疗的健康女性组成。所有因严重OHSS入院的个体中均检测到高浓度的IL-1、IL-6和TNF-α。随着临床改善，这些浓度显著下降，完全康复后达到正常值。在血浆细胞因子浓度与该综合征的某些生物学特征（如白细胞增多、血细胞比容增加和血浆17-β-雌二醇浓度升高）之间发现了具有统计学意义的相关性。从研究患者获得的腹水中IL-6和IL-8浓度较高，而其他细胞因子未发生改变。这些结果表明炎性细胞因子与卵巢过度刺激综合征的病理生理学密切相关。
