妊娠期Graves病患者体内CD3^(+)CD56^(+)NKT细胞表达与妊娠结局的相关性研究  

Correlation between CD3^(+)CD56^(+)NKT cell expression and pregnancy outcome in Graves patients during pregnancy

作　　者：窦文婷 罗婉莹[2] 陈月华 Dou Wenting;Luo Wanying;Chen Yuehua(Obstetrics Department,Dongguan Tungwah Hospital,Guangdong Province,Dongguan 523110,China)

机构地区：[1]东莞东华医院产科,广东东莞523110 [2]东莞东华医院内分泌科,广东东莞523110

出　　处：《海军医学杂志》2022年第5期522-526,共5页Journal of Navy Medicine

基　　金：东莞市社会科技发展项目(201850715046843)。

摘　　要：目的探讨CD3^(+)CD56^(+)NKT细胞在妊娠期Graves病(grave disease,GD)患者体内的表达情况及其与妊娠结局的相关性。方法选取2018年10月至2021年3月东莞东华医院收治的53例妊娠期GD患者作为GD组,同期选取53例正常妊娠者作为对照组。依据随访结果将GD组分为正常结局组、流产组、产后出血组、低出生体重儿组4个亚组。采用流式细胞仪检测CD3^(+)CD56^(+)NKT细胞的数目。抽取外周静脉血检测2组甲状腺激素游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)的水平及甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、甲状腺球蛋白抗体(thyroglobulin antibody,TGAb)和促甲状腺素受体抗体(thyrotropin receptor antibody,TRAb)的滴度。比较GD组与对照组间CD3^(+)CD56^(+)NKT细胞的数目与甲状腺激素、甲状腺激素抗体指标水平。分析GD组患者NKT细胞与甲状腺功能指标的相关性,GD组各亚组患者间CD3^(+)CD56^(+)NKT细胞数目差异,并分析细胞数目与妊娠结局的相关性。结果GD组患者外周血中CD3^(+)CD56^(+)NKT细胞的数目明显低于对照组,差异具有统计学意义(P<0.05);GD组患者血清中FT_(3)、FT_(4)、TPOAb、TGAb和TRAb水平明显高于对照组,差异具有统计学意义(P<0.05)。相关性分析显示,GD组患者血清中FT_(3)、FT_(4)、TPOAb、TGAb和TRAb水平与外周血中CD3^(+)CD56^(+)NKT细胞的数目呈负相关,差异具有统计学意义(P<0.05)。流产组、产后出血组、低出生体重儿组患者血清中CD3^(+)CD56^(+)NKT细胞的平均数目均低于正常结局组,差异具有统计学意义(P<0.05);调控年龄、BMI等因素后,CD3^(+)CD56^(+)NKT细胞的数目仍然是流产等不良妊娠结局的独立危险因素。结论CD3^(+)CD56^(+)NKT细胞在妊娠期Graves病患者体内表达降低,并与Graves病严重程度及不良妊娠结局具有一定的相关性,积极检测妊娠期Graves病患者CD3^(+)CD56^(+)NKT细胞表达水平�Objective To investigate the expression of CD3^(+)CD56^(+)NKT cells in Graves patients during pregnancy and the correlation with pregnancy outcome.Methods 53 patients with Graves’disease(GD)during pregnancy admitted to Dongguan Tungwah Hospital from October 2018 to March 2021 were enrolled as the GD group,while another 53 patients with normal pregnancy within the same time span were recruited as the control group.According to the follow-up results,the GD group was further divided into 4 subgroups:the normal outcome group,the abortion group,the postpartum hemorrhage group and the low birth weight group.Flow cytometry was used to detect the number of CD3^(+)CD56^(+)NKT cells.Peripheral venous blood was collected to detect the levels of free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),as well as the titers of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb)and thyrotropin receptor antibody(TRAb)in both groups.The number of CD3^(+)CD56^(+)NKT cells and the levels of thyroid hormone and thyroid hormone antibody were compared between the GD group and the control group.The correlation between NKT cells and thyroid function indexes in the GD group was analyzed,the differences in the number of CD3^(+)CD56^(+)NKT cells in the various subgroups of the GD group,as well as the correlation between cell number and pregnancy outcome were also analyzed.Results The number of CD3^(+)CD56^(+)NKT cells in the peripheral blood of the GD group was significantly less than that of the control group,with statistical significance(P<0.05).The serum levels of FT_(3),FT_(4),TPOAb,TGAb and TRAb in the GD group were significantly higher than those in the control group,also with statistical significance(P<0.05).Analyses indicated that the levels of FT_(3),FT_(4),TPOAb,TGAb and TRAb in the serum of the GD group were negatively correlated with the number of CD3^(+)CD56^(+)NKT cells in the peripheral blood,and statistical significance could be seen when comparisons were made between them(P<0.05).The average number of serum CD3^

关 键 词：CD3^(+)CD56^(+)NKT细胞 GRAVES病 妊娠期 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学] R581.1[医药卫生—临床医学]