CD4^＋CD25^high调节性T淋巴细胞在妊娠肝内胆汁淤积症发病中的作用  

Role of CD4^＋CD25^high regulatory T cells in the pathogenesis of intrahepatic cholestasis of pregnancy

作　　者：林莉[1] 张丽娟[1] 

机构地区：[1]中南大学湘雅二医院妇产科,长沙410011

出　　处：《中华妇产科杂志》2008年第12期900-903,共4页Chinese Journal of Obstetrics and Gynecology

基　　金：湖南省自然科学基金（07JJ5097）

摘　　要：目的探讨妊娠肝内胆汁淤积症（ICP）患者外周血与蜕膜组织CD4^＋CD25^调节性T淋巴细胞（Treg细胞）及CD4^＋CD25^high细胞在ICP发病中的作用。方法采用流式细胞仪检测30例ICP患者（ICP组，其中轻度15例，重度15例）及28例正常晚期妊娠妇女（对照组）外周血和蜕膜组织CD4^＋CD25^＋Treg细胞及CD4^＋CD25^high Treg细胞占CDfT淋巴细胞的百分率，分析其与ICP发病的关系。结果ICP组外周血CD4^＋CD25^＋ Treg细胞百分率为（7．96±1．32）％，CD4^＋CD25^high Treg细胞百分率为（0．78±0．22）％，均低于对照组[（17．05±2．86）％、（1．71±0．69）％]，分别比较，差异均有统计学意义（P〈0．01）；ICP组蜕膜组织CD4^＋CD25^＋ Treg细胞百分率为（17．18±2．27）％，CD4^＋CD25^high Treg细胞百分率为（2．25±0．89）％，也均低于对照组[（32．01±3．88）％、（8．30±1．13）％]，分别比较，差异也均有统计学意义（P〈0．01）。ICP组及对照组蜕膜组织中CD4^＋CD25^＋ Treg细胞及CD4^＋CD25^high Treg细胞百分率均高于外周血，差异均有统计学意义（P〈0．01）。ICP组轻度及重度患者外周血CD4^＋CD25^＋ Treg细胞百分率分别为（8．74±0．96）％、（7．17±1．17）％，CD4^＋CD25^high Treg细胞百分率分别为（0．89±0．20）％、（0．68±0．19）％，而蜕膜组织CD4^＋CD25^＋ Treg细胞百分率分别为（18．43±1．90）％、（15．94±1．95）％，CD4^＋CD25^high Treg细胞百分率分别为（2．62±0．72）％、（1．87±0．90）％，ICP组外周血及蜕膜组织CD4^＋CD25^high细胞及CD4^＋CD25^＋ Treg细胞百分率随着病情的加重呈下降趋势，分别比较，差异均有统计学意义（P〈0．05）。结论CD4^＋CD25^＋ Treg细胞及CD4^＋CD25^high Treg细胞可能参与ICP的发病过程，并与病情的严重程度密切相关。Objective To investigate the role of CD4^＋ CD25^＋ regulatory T cells and CD4^＋CD25^high regulatory T cells in peripheral blood and decidua in the pathogenesis of intrahepatic cholestasis of pregnancy （ICP）. Methods Peripheral blood and decidua CD4^＋CD25^＋ regulatory T cells and CD4^＋CD25^high regulatory- T ceils in 30 ICP patients（ 15 mild ICP and 15 severe ICP） and 28 normal pregnant women were analyzed by ＋ high flow eytometry. Results The percentage of CD4^＋CD25^＋ regulatory T cells and CD4^＋CD25^high regulatory T ceils in the CD4^＋ T cells population in both peripheral blood and deeidua in ICP patients were significantly lower than those in control women [（7.96 ± 1.32）% vs （17.05 ±2.86）%, （17.18±2.27）% vs （32.01 ± 3.88）% ;（0.78 ±0.22）% vs （1.71 ±0.69）%,（2.25±0.89）% vs （8.30±1.13）%;P〈0.01]. Meanwhile, a significantly higher percentage of CD4^＋CD25^＋ regulatory T cells and CD4^＋CD25^high regulatory T cells in the CD4^＋ T cells population was observed in all decidua samples compared to peripheral blood both in ICP patients （P 〈0. 01 ） and in control women （P 〈0. 01 ）. In addition,the percentages of CD4^＋CD25^＋ regulatory T cells and CD4^＋CD25^high regulatory T cells in the CD4^＋T cell population in both decidua and peripheral blood in severe ICP [ （ 15.94 ±1.95 ） %, （7.17 ±1.17 ） %, （ 1.87 ＋ 0. 90） %, （ 0. 68 ±0. 19 ） % ] were lower than those in mild ICP [ （ 18.43 ±1.90） %, （ 8.74 ±0. 96 ） %, （ 2. 62 ±0.72 ） %, （ 0. 89 ±0. 20 ） % ] and normal pregnancy （ all P 〈 0. 05 ）. Conclusions CD4^＋CD25^high regulatory T cell may play an important role in the pathogenesis of ICP and control of disease progression.

关 键 词：妊娠并发症 胆汁淤积 肝内 T淋巴细胞 流式细胞术 

分 类 号：R686[医药卫生—骨科学]