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目的通过观察使用米非司酮对引产胎儿细胞因子分泌、肝细胞增殖及肝功能的影响,探讨米非司酮对胎儿安全性的影响。方法胎儿娩出后立即抽取脐动脉血,应用全自动生化分析仪对胎儿肝功能进行检测;应用放射性同位素-胸腺嘧啶核苷(3H-radioactive isotope Thy midine,3H-TdR)掺入实验,体外研究米非司酮对胎儿肝细胞增殖活性的影响;放射免疫分析研究血清白细胞因子-2(interleukin-2,IL-2)及肿瘤坏死因子(tumor necrosis factor,TNF)-α的水平。结果孕妇体内米非司酮用药组胎儿的肝功能无明显变化,但是肝细胞增殖能力明显受抑制,在体外实验的高浓度和低浓度组,用药组与对照组肝细胞增殖能力有显著差别,差异有统计学意义(P<0.05),提示高浓度米非司酮单纯体外应用可以明显抑制胎儿肝细胞增殖。用药组IL-2明显升高,与未用药组有明显区别,差异有统计学意义(P<0.05),而TNF-α的水平两组间无明显差别,差异无统计学意义(P>0.05),提示米非司酮有明显的促进IL-2分泌的作用。结论米非司酮对胎儿肝脏功能无明显影响,但是可以抑制肝细胞的增殖,还可明显促进IL-2分泌,从而影响胎儿的免疫系统功能,使胎儿体内免疫抑制反应减弱,免疫排斥反应增强。提示米非司酮对胎儿的安全性有一定的影响。
Objective To investigate the effect of mifepristone on fetal safety by observing the effect of mifepristone on fetal cytokine secretion, hepatocyte proliferation and liver function in induced abortion. Methods Umbilical arterial blood was collected immediately after delivery and the fetal liver function was detected by automatic biochemical analyzer. 3H-TdR incorporation was performed in vitro. The effect of nifepristone on fetal liver cell proliferation and the level of interleukin-2 (IL-2) and tumor necrosis factor (TNF) -α by radioimmunoassay. Results The liver function of the fetuses in the mifepristone-treated group did not change significantly, but the proliferation of hepatocytes was significantly inhibited. In vitro and in vivo, there was a significant difference in the proliferation of hepatocytes between the drug-treated group and the control group. The difference was statistically significant (P <0.05), suggesting that high concentrations of mifepristone alone can significantly inhibit fetal liver cell proliferation in vitro. The level of IL-2 in the treatment group was significantly higher than that in the control group (P <0.05), while there was no significant difference between the two groups (P> 0.05) ), Suggesting that mifepristone has a significant role in promoting IL-2 secretion. Conclusion Mifepristone has no significant effect on fetal liver function, but it can inhibit the proliferation of liver cells, but also significantly promote the secretion of IL-2, thus affecting the fetus’s immune system function, reducing the immunosuppression in the fetus, and enhancing immune rejection . Tip mifepristone has a certain impact on the safety of the fetus.