不明原因复发性流产患者再次妊娠早孕期外周血Treg及Th17细胞与妊娠结局关系的研究  

Relationship between peripheral Treg/Th17 cells and pregnancy outcomes in the first trimester of patients with unexplained recurrent spontaneous abortion

作　　者：杨丽[1] 唐明燕[1] 徐珍珍[1] 高爱华[1] 张弘[1] 

机构地区：[1]苏州大学附属第二医院妇产科,215000

出　　处：《中华检验医学杂志》2017年第3期174-179,共6页Chinese Journal of Laboratory Medicine

基　　金：江苏省高校自然科学研究面上项目（14KJB320016）

摘　　要：目的研究不明原因复发性流产（URSA）患者再次妊娠早孕期外周血Treg及Th17细胞与妊娠结局的关系。方法采用前瞻性研究方法，选择2014年1月至2015年6月就诊于苏州大学附属第二医院生殖内分泌门诊的URSA再次妊娠早孕期患者60例为研究组，选取同期就诊于同一医院既往无自然流产史的正常早孕妇女56名为对照组，采用流式细胞技术测定研究组及对照组早孕期外周血调节性T细胞（Treg）、辅助性T细胞17（Th17）、CD4＋辅助性T细胞（CD4＋ T细胞）及总淋巴细胞数目，并分别计算Treg/CD4＋ T细胞比值、Th17/CD4＋ T细胞比值、Treg/总淋巴细胞比值、Th17/总淋巴细胞比值以及Treg/Th17比值。随访研究组与对照组妊娠结局。根据随访到的不同的妊娠结局分为URSA妊娠成功分娩组（23例）、URSA妊娠再次流产组（37例）及正常妊娠成功分娩组（44例）。使用Wilcoxon秩和检验进行组间两两比较。结果URSA妊娠再次流产组与URSA妊娠成功分娩组比较，CD4＋ T细胞数目[（1 570.16±519.56）和（1 571.83±450.37），t＝0.01，P＝0.99]、总淋巴细胞数目[（4 497.11±975.48）和（4 558.52±1 032.54），t＝0.23，P＝0.82]之间差异无统计学意义，而Treg/CD4＋ T细胞比值[（1.09±0.62）和（3.32±2.30），t＝4.55，P＝0.000 1]、Treg/总淋巴细胞比值[（0.42±0.24）和（1.31±1.14），t＝3.67，P＝0.001 3]及Treg/Th17比值[（0.56±0.41）和（2.51±2.38），t＝3.89，P＝0.000 8]降低，Th17/CD4＋ T细胞比值[（1.85±0.92）和（0.93±0.36），t＝5.40，P〈0.001]、Th17/总淋巴细胞比值[（0.64±0.31）和（0.31±0.14），t＝5.52，P〈0.001]增高。URSA妊娠再次流产组与正常妊娠成功分娩组比较，CD4＋ T细胞数目[（1 570.16±519.56）和（1 566.86±651.36），t＝0.03，P＝0.98]、总淋巴细胞数目[（4 497.11±975.48）和（4 720.91±1 572.92），t＝0.78，P＝0.44）之间差异无统计学意义，而TObjective To investigate Treg and Th17 cell numbers in the peripheral blood of patients with unexplained recurrent spontaneous abortion （URSA）, with an aim to elevate their potential for predicting pregnancy outcomes. Methods Peripheral blood was collected from 60 URSA pregnant women and 56 healthy pregnant women during their first trimester in the Department of Reproductive Endocrinology of the Second Affiliated Hospital of Sooehow University from January 2014 to June 2015. The counts of regulatory T cell （Treg）, T helper cell 17 （Th17）, CD4 positive T cell （CD＋ T cell） and total lymphocytes in the peripheral blood were determined by flow cytometry. Calculated the ratios of Treg/CD4＋ T cells, Treg/total lymphocytes, Th17/CD4 ＋ T cells, Th17/total lymphoeytes and Treg/Th17, then the pregnancy outcomes were followed up. According to the different pregnancy outcomes, the patients were divided into three groups： URSA successful delivery group （23 cases）, URSA re-miscarriage group （37 cases） and normal successful delivery group （44 cases）. Non-parametric test were used to compare the differences between groups. Results There were no difference between the URSA re-miscarriage group and URSA successful delivery group in the CD4＋ T cell counts[ （1 570. 16 ±519. 56） vs （1 571.83 ±450. 37）, t = 0.01,P = 0. 99 ] and total lymphoeytes [ （4 497. 11 ± 975.48 ） vs （4 558. 52 ± 1 032. 54）, t = 0. 23, P = 0.821. However, the ratios of Treg/CD4＋ T cells[（1.09 ±0.62） vs （3.32 ± 2. 30）, t= 4. 55, P=0.0001], Treg/totallymphocytes[（0.42±0.24） vs （1.31 ± 1.14）, t=3.67, P=0.001 31and Treg/Thl7 [ （0. 56 ±0. 41 ） vs （2. 51 ±2. 38） ,t =3.89,P =0. 000 8] in the URSA miscarriage again group were significantly lower whereas the ratios of Thl7/CD4 ＋ T cells [ （ 1.85 ± 0. 92 ） vs （ 0. 93 ± 0. 36 ）, t = 5.40, P 〈 0. 001 ] and Th17/total lymphocytes [ （ 0. 64 ± 0. 31 ） vs （ 0. 31 ± 0. 14 ）, t = 5.52, P 〈 0. 001 ] were significantly

关 键 词：流产 习惯性 妊娠初期 T淋巴细胞 调节性 THL7细胞 

分 类 号：R446.6[医药卫生—诊断学] R714.21[医药卫生—临床医学]