目的 探讨苯并[a]芘(benzo[a]pyrene,B[a]P)宫内暴露与胚胎停育的关联,以及辅助性T细胞1/辅助性T细胞2(helper T cell 1/helper T cell 2,Th1/Th2)平衡偏移的中介效应.方法 选取胚胎停育患者与正常妊娠但自愿人工流产的女性作为研究对象(245名).检测研究对象绒毛组织中 7,8-二羟-9,10-环氧苯并[a]芘(7,8-dihydroxy-9,10-epoxy-benzo[a]pyrene,BPDE)-DNA 加合物与白细胞介素(interleukin,IL)-2、干扰素-γ(interferon-γ,IFN-γ)、IL-4、IL-10水平.采用logistic回归分析模型分析B[a]P暴露与胚胎停育的关联,运用Bootstrap法分析Th1/Th2平衡偏移的中介效应.结果 调整协变量后,BPDE-DNA加合物的中高暴露、高暴露水平发生胚胎停育的风险分别是低暴露水平的5.66倍(aOR=5.66,95％CI:2.00～16.01,P＜0.001)、5.63倍(aOR=5.63,95％CI:1.97～16.14,P＜0.001);中介分析结果显示,B[a]P对胚胎停育的总效应为1.220(0.501～1.939),Th1/Th2平衡偏移介导的中介效应为0.328(0.078～0.716),中介比例占26.89％.结论 B[a]P暴露是胚胎停育的危险因素,且Th1/Th2失衡发生Th1型偏移是B[a]P暴露致胚胎停育的中介变量.
The mediating effect of Th1/Th2 balance deviation in the association between B[a]P intrauterine exposure and embryonic arrest
Objective To investigate the association between exposure to benzo[a]pyrene(B[a]P)and embryonic arrest,and the mediating effects of helper T cell 1/helper T cell 2(Th1/Th2)balance deviation.Methods A total of 245 women with embryonic arrest and women with normal pregnancy who voluntarily induced abortion were selected as the study objects.The levels of 7,8-dihydroxy-9,10-epoxy-benzo[a]pyrene(BPDE)-DNA adducts and interleukin(IL)-2,interferon-γ(IFN-γ),IL-4,IL-10 in villus tissues were detected.Logistic regression model was used to analyze the correlation between B[a]P exposure and embryonic arrest,and Bootstrap method was used to analyze the mediating effect of Th1/Th2 balance deviation between them.Results After adjusting for covariates,it was found that the risk of embryonic arrest at medium-high exposure level and high exposure level of BPDE-DNA adducts was 5.66 times(aOR=5.66,95％CI:2.00-16.01,P＜0.001)and 5.63 times(aOR=5.63,95％CI:1.97-16.14,P＜0.001)higher than that at low exposure level,respectively;The results of mediating analysis showed that B[a]P had a total effect of 1.220(0.501-1.939)on embryonic arrest,with a mediating effect caused by Th1/Th2 balance deviation of 0.328(0.078-0.716),accounting for 26.89％.Conclusions B[a]P exposure is a risk factor for embryonic arrest,and Th1/Th2 imbalance occurring with a Th 1-Type deviation is a mediating variable of embryonic arrest caused by B[a]P exposure.
Benzo[a]pyreneEmbryonic arrestHelper T cell 1/helper T cell 2Balance deviationMediating effect
万方数据
维普
