妊娠期高血压疾病患者胎盘免疫细胞数与围生结局的相关性研究  

The correlation between the number of placental immune cells and perinatal outcomes in hypertensive disorders complicating pregnancy

作　　者：钟辉[1] 晋兴林 蒋玉芬[2] 化金金 龙璐雯 马静[1] 倪萍 钟文娜 Zhong Hui;Jin Xinglin;Jiang Yufen(Department of Pathology,Huaibei Maternal and Child Health Care Hospital,Huaibei 235000;Department of Obstetrics,Huaibei Maternal and Child Health Care Hospital,Huaibei 235000)

机构地区：[1]淮北市妇幼保健院病理科,淮北235000 [2]淮北市妇幼保健院产科,淮北235000

出　　处：《现代妇产科进展》2024年第12期900-904,909,共6页Progress in Obstetrics and Gynecology

基　　金：安徽省淮北市科技局市级科研课题(No:2021HK031)。

摘　　要：目的:探讨妊娠期高血压疾病(HDCP)患者胎盘免疫细胞数与围生结局的相关性。方法:选取2019年7月~2022年8月于淮北市妇幼保健院住院分娩的75例HDCP产妇(观察组)和75例健康产妇(对照组)。比较各组产妇胎盘底蜕膜中免疫细胞表达情况,包括CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD56^(+)自然杀伤(NK)细胞、CD68^(+)巨噬细胞,以及不良妊娠结局。通过二元logistic回归分析法评估胎盘底蜕膜中免疫细胞表达与HDCP患者围生结局之间的关系。结果:观察组胎盘底蜕膜中CD3^(+)T细胞、CD8^(+)T细胞、CD68^(+)巨噬细胞表达水平均显著高于对照组(P<0.05)。妊娠期高血压组胎盘底蜕膜中CD3^(+)T细胞、CD8^(+)T细胞、CD56^(+)NK细胞、CD68^(+)巨噬细胞表达水平均显著低于子痫前期组(P<0.05)。妊娠期高血压组的不良妊娠发生率为18.75%,子痫前期组为27.27%,差异无统计学意义(P>0.05)。HDCP不良妊娠结局组胎盘底蜕膜中CD3^(+)T细胞、CD8^(+)T细胞、CD68^(+)巨噬细胞表达水平均显著高于非不良妊娠结局组(P<0.05)。多因素二元logistic回归分析结果显示,校正年龄、孕次、产次、疾病类型等混杂因素后,CD3^(+)T细胞、CD8^(+)T细胞、CD68^(+)巨噬细胞的阳性表达是HDCP患者发生不良妊娠结局的独立危险因素(P<0.05)。结论:HDCP患者胎盘中免疫细胞CD3^(+)T细胞、CD8^(+)T细胞、CD68^(+)巨噬细胞均呈高表达状态,且CD3^(+)T细胞、CD8^(+)T细胞、CD68^(+)巨噬细胞的阳性表达是影响HDCP患者围生结局的独立危险因素。Objective:To investigate the correlation between the number of placental immune cells and perinatal outcomes in patients with hypertensive disorders complicating pregnancy(HDCP).Methods:75 women with HDCP and 75 healthy women who gave birth in our hospital from July 2019 to August 2022 were selected.The expression of immune cells in decidua placenta base was compared,included CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,CD56^(+)natural killer(NK)cells,and CD68^(+)macrophages.To compare the adverse pregnancy outcomes of women with different types of HDCP.Binary logistic regression analysis was used to evaluate the relationship between immune cell expression in decidua placenta basalis and perinatal outcomes in HDCP patients.Results:The expression levels of CD3^(+)T cells,CD8^(+)T cells and CD68^(+)macrophages in decidua placenta base in observation group were significantly higher than those in control group(P<0.05).The expression levels of CD3^(+)T cells,CD8^(+)T cells,CD56^(+)NK cells and CD68^(+)macrophages in decidua placenta base in gestational hypertension group were significantly lower than those in preeclampsia group(P<0.05).The incidence of adverse pregnancy was 18.75%in the hypertensive group and 27.27%in the preeclampsia group,and there was no statistical significance between the groups(P>0.05).The expression levels of CD3^(+)T cells,CD8^(+)T cells and CD68^(+)macrophages in decidua placenta bottom in HDCP adverse pregnancy outcome group were significantly higher than those in non-adverse pregnancy outcome group(P<0.05).Multivariate binary logistic regression analysis showed that after adjusting for confounding factors such as age,pregnancy,birth and disease type,the positive expressions of CD3^(+)T cells,CD8^(+)T cells and CD68^(+)macrophages were independent risk factors for adverse pregnancy outcomes in HDCP patients(P<0.05).Conclusion:CD3^(+)T cells,CD8^(+)T cells and CD68^(+)macrophages were highly expressed in the placenta of HDCP patients,and the positive expressions of CD3^(+)T cells,CD8^(+)T cel

关 键 词：妊娠期高血压疾病 胎盘 免疫细胞 围生结局 

分 类 号：R714.2[医药卫生—妇产科学]