Wilson R, McInnes I, Leung B, McKillop J H, Walker J J
Department of Medicine, Glasgow Royal Infirmary, UK.
Eur J Obstet Gynecol Reprod Biol. 1997 Dec;75(2):211-4. doi: 10.1016/s0301-2115(97)00124-3.
The causes of recurrent miscarriage are not fully understood. Recent studies have suggested that whilst a TH 2 type immune response may be associated with a healthy pregnancy, miscarriage may be associated with a TH 1 type response. Serum levels of nitric oxide (NO) and Interleukin 12 (IL 12) were measured in; healthy non-pregnant women; healthy pregnant women; women suffering spontaneous abortion; pregnant women with a history of recurrent miscarriage; non-pregnant women with a history of recurrent miscarriage. Normal pregnancy was associated with a significant decrease in serum levels of nitrite (13.0 vs. 22.0 P < 0.0001). In women admitted with spontaneous abortion there was a significant increase in the levels of nitrite (16.0 vs. 13.0 P < 0.05), but no change in IL 12 compared to normal pregnant women. In pregnant women with a history of recurrent miscarriage levels of nitrite (16.0 vs. 13.0 P < 0.05) and IL 12 (10.0 vs. 6.0 P < 0.0006) were significantly elevated compared to normal pregnancy. When these women were sampled prior to becoming pregnant the levels of NO were found to be significantly lower than those in the non-pregnant control group (13.1 vs. 22.0 P < 0.05) although levels of IL 12 were unchanged. No correlation was found between serum nitrite and IL 12 levels. This report further supports the idea that polarisation of the immune response during pregnancy may predispose to recurrent miscarriage.
复发性流产的病因尚未完全明确。近期研究表明,虽然TH2型免疫反应可能与正常妊娠相关,但流产可能与TH1型反应有关。研究测定了以下几组人群血清中的一氧化氮(NO)和白细胞介素12(IL 12)水平:健康未孕女性;健康孕妇;自然流产女性;有复发性流产史的孕妇;有复发性流产史的未孕女性。正常妊娠与血清亚硝酸盐水平显著降低相关(13.0对22.0,P<0.0001)。自然流产女性的亚硝酸盐水平显著升高(16.0对13.0,P<0.05),但与正常孕妇相比,IL 12水平无变化。有复发性流产史的孕妇,亚硝酸盐(16.0对13.0,P<0.05)和IL 12(10.0对6.0,P<0.0006)水平相比正常妊娠显著升高。当对这些女性在怀孕前进行采样时,发现NO水平显著低于未孕对照组(13.1对22.0,P<0.05),尽管IL 12水平未变。血清亚硝酸盐和IL 12水平之间未发现相关性。本报告进一步支持了孕期免疫反应极化可能易导致复发性流产这一观点。