MIF和HLA-DR表达在自身免疫性卵巢早衰患者临床意义  

Clinical significance of MIF and HLR-DR antigens in patients with autoimmune premature ovarian failure

作　　者：陈云霞[1] 白巍 杨步琴 李大志[1] 王丽[1] CHEN Yun-xia;BAI Wei;YANG Bu-qin;LI Da-zhi;WANG Li(Department of Gynecology and Obstetrics,People’s Hospital of Baoan District,Shenzhen 518101,Guangdong,China)

机构地区：[1]深圳市宝安区人民医院妇产科

出　　处：《生物医学工程与临床》2019年第6期714-718,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨巨噬细胞移动抑制因子(MIF)和人类白细胞DR抗原(HLA-DR)表达在自身免疫性卵巢早衰(APOF)患者的表达及其临床意义。方法选择深圳市宝安区人民医院2016年1月至2018年1月诊治的60例卵巢早衰患者,年龄21~39岁,平均年龄32.58岁。根据病因分为:观察组30例,诊断为APOF;对照组30例,诊断为非APOF。另选取30例健康绝经妇女作为绝经组(年龄59~67岁,平均年龄63.26岁)。检测并比较3组外周血抗卵巢抗体(AOAb)、抗透明带抗体、抗核抗体(ANA)、MIF和淋巴细胞HLA-DR表达水平。采用Pearson相关分析评估血清MIF与HLA-DR间的相关性。根据年龄(> 30岁组和≤30岁组)和病程(> 3年组和≤3年组)进行分组,比较血清MIF与HLA-DR水平的差异。应用多元Logistic回归分析上述各临床指标与APOF发病的相关性。绘制受试者工作特征曲线(ROC)评估血清MIF与HLA-DR水平对APOF患者的临床诊断价值。结果观察组与对照组患者的AOAb、抗透明带抗体、ANA水平差异无统计学意义(P> 0.05),但均高于绝经组(P <0.05);观察组血清MIF和HLA-DR水平最高,对照组次之,绝经组最低(P <0.05)。观察组中年龄> 30岁组MIF水平明显高于年龄≤30岁组(P <0.05);但在年龄亚组中HLA-DR水平未见差异(P> 0.05)。病程> 3年组MIF和HLA-DR水平明显高于病程≤3年组(P <0.05)。Pearson相关分析显示APOF患者血清MIF与HLA-DR呈负相关(P <0.05)。多元Logistic回归分析显示,血清MIF、HLA-DR+CD3、HLA-DR+CD19为APOF的危险因素(OR=2.135,P=0.030;OR=2.867,P=0.024;OR=2.779,P=0.036)。血清MIF及HLA-DR联合,诊断APOF的AUC最大为0.878,P值为0.028,其灵敏度84.5%,特异度86.7%。结论 APOF患者外周血存在MIF和HLA-DR高水平,在一定程度上反映卵巢早衰患者存在免疫紊乱,可作为临床早期诊断的主要参考指标。Objective To explore the expression and clinical significance of macrophage migration inhibitory factor(MIF) and human leukocyte DR antigen(HLA-DR) antigen in patients with autoimmune premature ovarian failure(APOF). Methods From January 2016 to January 2018, a total of 60 premature ovarian failure patients were enrolled, which aged 21-39 years old with mean age of 32.58 years old. All of the patients were divided into observation group(n = 30, with APOF) and control group(n = 30, with non-APOF). Another 30 contemporaneous healthy postmenopausal females(aged 59-67 years old with mean age of 63.26 years old) were enrolled as postmenopausal group. The serum levels of antiovarian antibody( AOAb), anti-zone pellucida antibody(AZPA), antinuclear antibody(ANA), MIF and HLA-DR were detected and compared in 3 groups. The correlations of MIF and HLA-DR were confirmed by Pearson linear correlation analysis. The patients were divided into sub-group according to age(> 30-year-old group and ≤ 30-year-old group) and duration(> 3 years group and ≤ 3 years group). The serum levels of MIF and HLR-DR were compared between sub-groups. The risk factors of APOF were confirmed by multivariate Logistic analysis. The receiver operation characteristic(ROC) curve was drawn to evaluate the clinical diagnostic value of MIF and HLA-DR levels in APOF patients. Results The levels of AOAb, AZPA and ANA were not different between observation group and control group(P > 0.05), but were higher than those of postmenopausal group(P < 0.05). The MIF and HLADR levels in observation group were the highest, and that of control group were middle and postmenopausal group was the lowest(P < 0.05). The MIF level in > 30-year-old group was significantly higher than that in ≤ 30-year-old group(P < 0.05),while there was no difference in HLA-DR level between different age groups(P > 0.05). The MIF and HLA-DR levels in duration > 3 years group were significantly higher than those in ≤ 3 years group(P < 0.05). The Pearson analysis results showed the negat

关 键 词：巨噬细胞移动抑制因子(MIF) 人类白细胞DR抗原(HLA-DR) 自身免疫性卵巢早衰 早期诊断 

分 类 号：R711.75[医药卫生—妇产科学]