不明原因复发性流产患者外周血Th1/Th2和单核细胞上Tim-3、PD-1表达及临床意义  

Expressions and clinical significances of Th1/Th2 cytokine in peripheral blood,and Tim-3 and PD-1 in peripheral blood mononuclear cells of women with unexplained recurrent miscarriage

作　　者：黄健 王秀琪 杨和 HUANG Jian;ZHANG Rui;TANG Yong(Hainan Western Central Hospital,Danzhou,Hainan Province,571700)

机构地区：[1]海南西部中心医院,儋州571700

出　　处：《中国计划生育学杂志》2023年第7期1522-1526,共5页Chinese Journal of Family Planning

基　　金：海南省医药卫生科研项目(20A200436)。

摘　　要：目的:探讨不明原因复发性流产(URSA)患者外周血中T辅助细胞1/T辅助细胞2(Th1/Th2)失衡及外周血单个核细胞(PBMC)上T细胞免疫球蛋白黏蛋白-3(Tim-3)、程序性死亡因子1(PD-1)的表达及其临床诊断意义。方法:收集2019年1月—2021年12月本院诊治的61例URSA备孕患者为URSA组,健康体检的备孕妇女61例为对照组。检测外周血Th1/Th2细胞,白介素-4(IL-4)、干扰素-γ(INF-γ);密度梯度离心法分离PBMC后检测Tim-3、PD-1表达情况,分析各项指标相关性及其诊断URSA价值。结果:URSA组Th1细胞亚群及Th1/Th2比、IFN-γ及IFN-γ/IL-4比均高于对照组,Th2细胞亚群、IL-4水平、PBMC上Tim-3(3.12±0.53)、PD-1(2.69±0.38)表达量均低于对照组(4.79±0.82、4.05±0.42);URSA患者外周血Th1/Th2细胞比、IFN-γ/IL-4比均与PBMC上Tim-3、PD-1表达量呈负相关性,Tim-3与PD-1表达量呈正相关性(均P<0.05)。以Th1/Th2比、IFN-γ/IL-4比、Tim-3和PD-1进行受试者工作曲线分析,曲线下面积分别为0.709、0.642、0.691、0.614。结论:Th1/Th2平衡在URSA患者中呈Th1优势,并伴有PBMC上Tim-3、PD-1低表达,Th1/Th2失衡与Tim-3、PD-1低表达有关,可能参与了URSA的发生发展进程,可作为临床诊治的潜在靶点。Objective:To investigate the expressions and clinical significances of T helper cell 1/T helper cell 2(Th1/Th2)in peripheral blood,and T cell immunoglobulin mucin-3(Tim-3)and programmed death factor 1(PD-1)in peripheral blood mononuclear cells(PBMC)of women with unexplained recurrent miscarriage(URSA).Methods:A total of 61women with URSA were collected in study group,and 61women who were preparing for pregnancy after the physical examination were collected in control group from January 2019to December 2021.The condition of Th1/Th2 cells,and the levels of interleukin-4(IL-4)and interferon-γ(INF-γ)in peripheral blood of the women in the two groups were detected.The density gradient centrifugation method was used to separate PBMC,and the expressions of Tim-3and PD-1in PBMC of the women in the two groups were detected.The correlations of the above various indicators among each other were analyzed,and their values for diagnosing URSA were also analyzed.Results:The values of Th1cell subsets,the Th1/Th2ratio,the IFN-γlevel,and the IFN-γ/IL-4ratio of the women in the study group were significantly higher than those of the women in the control group,but the Th2cell subsets values and the IL-4 level of the women in the study group were significantly lower.The expression values of Tim-3(3.12±0.53)and PD-1(2.69±0.38)in PBMC of the women in the study group were significantly lower than those(4.79±0.82and 4.05±0.42)of the women in the control group.The Th1/Th2cell ratio and IFN-γ/IL-4ratio in peripheral blood of the women with URSA were negatively correlated with their expression values of Tim-3and PD-1in PBMC,while theTim-3 expression value of the women with URSA was positively correlated with their PD-1expression value(all P<0.05).The areas under the receiver operator characteristic curve of the Th1/Th2ratio,the IFN-γ/IL-4ratio,and the expression values of Tim-3and PD-1of the women for diagnosing their URSA were 0.709,0.642,0.691,and 0.614,respectively.Conclusion:The balance of Th1/Th2of the women with URSA present

关 键 词：不明原因复发性流产 T辅助细胞 单个核细胞 T细胞免疫球蛋白黏蛋白-3 程序性死亡因子1 相关性 

分 类 号：R714.21[医药卫生—妇产科学]