AITD患者妊娠早期T细胞水平变化及妊娠结局  

Changes in T cell levels in early pregnancy and pregnancy outcomes of women with pregnancy associated with AITD

作　　者：钟玫[1] 余劲明[1] 蓝春勇[3] 兰娇[2] 粱岚 张莉[1] 钟华[1] 谭晓燕 卢杰 周幸 ZHONG Mei;YU Jinming;LAN Chunyong;LAN Jiao;LIANG Lan;ZHANG Li;ZHONG Hua;TAN Xiaoyan;LU Jie;ZHOU Xing(Department of Endocrinology and Metabolism,The People's Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences),Guangxi Nanning 530021,China;Scientific Research and Experimental Center,The People's Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences),Guangxi Nanning 530021,China;Department of Ultrasonography,The People's Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences),Guangxi Nanning 530021,China;Department of Gynecology,The People's Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences),Guangxi Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院(广西医学科学院)内分泌代谢科,广西南宁530021 [2]广西壮族自治区人民医院(广西医学科学院)科研试验中心,广西南宁530021 [3]广西壮族自治区人民医院(广西医学科学院)超声科,广西南宁530021 [4]广西壮族自治区人民医院(广西医学科学院)妇科,广西南宁530021

出　　处：《中国妇幼健康研究》2023年第10期32-39,共8页Chinese Journal of Woman and Child Health Research

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2019087)。

摘　　要：目的探讨妊娠早期合并自身免疫性甲状腺疾病(AITD)患者的调节性T细胞(Treg)和T细胞亚群水平变化及不良妊娠结局的影响因素。方法选取2018年12月至2021年12月在广西壮族自治区人民医院产前检查的合并AITD妊娠早期患者124例为观察组,另选取同期健康的妊娠早期孕妇80例为对照组。比较两组患者Treg细胞和T细胞亚群水平,采用多因素Logistic回归分析妊娠早期合并AITD患者不良妊娠结局的影响因素。结果观察组Treg、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)显著低于对照组,CD8^(+)显著高于对照组(t值分别为3.542、4.259、5.192、8.499、5.090,P<0.05)。多因素Logistic回归分析发现,年龄、孕前体质量指数(BMI)、CD8^(+)是妊娠早期合并AITD患者不良妊娠结局的危险因素,OR值及其95%CI分别为1.232(1.058~2.614)、2.493(1.181~3.429)、2.368(1.269~3.558);Treg、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)是其保护因素,OR值及其95%CI分别为0.886(0.327~0.935)、0.717(0.518~0.972)、0.935(0.764~0.993)、0.848(0.406~0.946),P<0.05。结论妊娠早期合并AITD患者的Treg、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平下降,CD8^(+)水平升高,更容易发生不良妊娠结局。Objective To investigate changes in regulatory T cells(Treg)and T cell subsets levels in early pregnancy of women with pregnancy associated with autoimmune thyroid disease(AITD)and their impacts on pregnancy outcomes.Methods A total of 124 pregnant women in first-trimester of pregnancy associated with AITD who received prenatal examination in the People's Hospital of Guangxi Zhuang Autonomous Region from December 2018 to December 2021 were selected as observation group,and 80 healthy pregnant women in first-trimester of pregnancy during the same period were selected as control group.The serum levels of Treg and T cell subsets of the pregnant women were compared between the two groups.Multivariate Logistic regression analysis were used to screen influencing factors for adverse pregnancy outcomes in pregnant women with AITD in early pregnancy.Results The serum levels of Treg,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)of the pregnant women in the observation group were significantly lower than those in the control group,while their serum level of CD8^(+)was significantly higher than that in the control group(t=3.542,4.259,5.192,8.499 and 5.090 respectively,all P<0.05).Multivariate Logistic regression analysis shown that age,pre-pregnancy body mass index(BMI)and serum level of CD8^(+)were risk factors for adverse pregnancy outcomes in the pregnant women with AITD in early pregnancy,while Treg,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were the protective factors.Their OR values and 95%CI were 1.232(1.058-2.614),2.493(1.181-3.429),2.368(1.269-3.558),0.886(0.327-0.935),0.717(0.518-0.972),0.935(0.764-0.993)and 0.848(0.406-0.946)respectively,all P<0.05.Conclusion The serum levels of Treg,CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)decrease in early pregnancy of the women with pregnancy associated with AITD,while their serum CD8^(+)level increases,and the pregnant women in early pregnancy who are associated with AITD are more likely to have adverse pregnancy outcomes.

关 键 词：妊娠早期 自身免疫性甲状腺疾病 调节性T细胞 T细胞亚群 妊娠结局 

分 类 号：R173[医药卫生—妇幼卫生保健]