动态检测孕妇血中NK、Treg细胞水平在早期预测子痫前期中的作用  

Study on the role of NK and Treg cells levels in maternal peripheral blood for early prediction of preeclampsia

作　　者：王健 杨晶[2] 朱壮彦 穆雅琴 王喜英 张海燕 张晋华[3] 赵富玺 WANG Jian;YANG Jing;ZHU Zhuangyan;MU Yaqin;WANG Xiying;ZHANG Haiyan;ZHANG Jinhua;ZHAO Fuxi(Immunology Institute,Shanxi Datong University,Datong 037009,China;Department of Hematology,the Fifth People＇s Hospital of Datong,Datong 037009,China;Department of Orthopedics,the Fifth People＇s Hospital of Datong,Datong 037009,China)

机构地区：[1]山西大同大学医学院免疫学研究所,037009 [2]大同市第五人民医院血液科,037009 [3]大同市第五人民医院骨科,037009

出　　处：《免疫学杂志》2018年第9期778-784,共7页Immunological Journal

基　　金：国家自然科学基金项目(81170621);山西省高等学校科技创新项目(2017165);大同市基础研究项目(2016115);大同市应用基础研究计划项目(2017139)

摘　　要：目的探讨妊娠早、中期孕妇外周血中NK、Treg细胞数量和表型的动态变化及其在子痫前期发病中的预测作用。方法选取280名孕妇随访观察,在其妊娠7~27周分阶段采集外周血,采用流式细胞分析技术检测NK和Treg细胞水平,并对NK细胞CD56^(dim)CD16^+和CD56^(bright)CD16^-表型变化进行比较,应用酶联免疫吸附实验测定相关细胞因子IFN-γ和IL-10的含量。同时监测孕妇血压、尿蛋白量、肝肾功能的异常变化并记录患者临床表现,将最终发展为子痫前期的孕妇归为PE组,从随访对象中随机选择相同例数正常妊娠者作为对照组。回顾性分析2组孕妇在妊娠早、中期外周血中NK、Treg细胞数量、表型及IFN-γ和IL-10的变化情况。结果子痫前期患者外周血中NK细胞及Treg细胞异常变化始于妊娠14~20周,且CD56^(dim)CD16^+NK细胞所占比例与Treg细胞数量在轻、重度PE组间差异有统计学意义(P<0.05);PE患者血中细胞因子IFN-γ和IL-10浓度异常出现在妊娠21~27周,且其水平变化与疾病严重程度相关;在妊娠21~27周,重度早发型PE组CD56^(dim)CD16^+NK/Treg的比值明显高于晚发型PE组(P<0.05)。结论检测妊娠中期孕妇血中NK/Treg失衡现象对PE发生和发展的预测具有重要价值。To dynamically detect the number and phenotypic changes of NK and Treg cells from the maternal peripheral blood in the first and second trimesters,and explore the predictive value in preeclampsia progress. 280 cases of pregnant women were selected for follow-up observation,the peripheral blood was collected by stages at 7-27 weeks of gestation. The levels of NK and Treg cells were detected by flow cytometry,the comparison of phenotype between CD56^（dim）CD16~＋ and CD56^（bright）CD16^- in NK cells was also carried out,the concentrations of IFN-γ and IL-10 were determined by enzyme-linked immunosorbent assay（ELISA）. Meanwhile,maternal blood pressure,urine protein,dysfunction of liver and kidney and clinical symptoms were monitored,the pregnant women who eventually developed into preeclampsia were selected as PE group,the same number of normal pregnant women were selected as control group from the follow-up pregnant women. Thequantity and phenotype changes of NK,Treg cells and the levels of IFN-γ and IL-10 in the peripheral blood of two groups in the first and second trimesters were analyzed,retrospectively. The abnormal changes of NK and Treg cells in peripheral blood of preeclamptic patients began at 14-20 weeks of gestation,and the proportion of CD56^（dim）CD16~＋ NK cells and the number of Treg cells between mild and severe PE group had significant difference（P〈0.05）. The abnormal concentrations of IFN-γ and IL-10 in PE patients began at 21-27 weeks of gestation,and their level changes were related to the severity of disease. At 21-27 weeks of gestation,the ratio of CD56^（dim）CD16~＋ NK cells to Treg cells in early onset group was higher than that in late onset group（P〈0.05）. The detection of NK/Treg imbalance in peripheral blood of pregnant women in the second trimester is of great value for predicting the occurrence and development of PE.

关 键 词：子痫前期 NK细胞 TREG细胞 产前诊断 

分 类 号：R392.9[医药卫生—免疫学]