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目的探讨母-胎界面子宫自然杀伤细胞免疫表型及辅助性 T 淋巴细胞(Th)1、2免疫状态的变化与子痫前期发病的关系。方法于剖宫产时采集20例子痫前期患者(子痫前期组)及11例正常妊娠妇女(正常对照组)的子宫底蜕膜组织,应用流式细胞技术检测两组产妇底蜕膜组织中子宫自然杀伤细胞亚群,子宫自然杀伤细胞表面受体 CD_(69)、CD_(94)及 Th1/Th2免疫状态。结果 (1)子痫前期组底蜕膜组织中子宫自然杀伤细胞 CD_(56) ~(bright)CD_(16)~-亚群及 CD_(56) ~(dim)CD_(16)~-亚群的含量分别为(17.3±11.1)%及(16.3±8.7)%,正常对照组分别为(17.9±16.8)%及(16.2±8.8)%,两组分别比较,差异无统计学意义(P>0.05)。(2)子痫前期组底蜕膜组织中子宫自然杀伤细胞 CD_(56)~+CD_(69)~+及 CD_(56)~+CD_(94)~+的含量分别为(37.9±18.9)%及(34.9±15.2)%,正常对照组分别为(36.8±19.7)%及(32.7±16.2)%,两组分别比较,差异无统计学意义(P>0.05)。(3)子痫前期组 CD_(56)~+CD_(69)~+/CD_(56)~+CD_(94)~+值为1.1±0.2,正常对照组为1.2±0.6,两组比较,差异无统计学意义(P>0.05)。(4)子痫前期组底蜕膜组织中细胞毒性 T 淋巴细胞(Tc)2型细胞含量为(3.0±1.0)%,正常对照组为(4.3±0.9)%,两组比较,差异有统计学意义(P<0.001);子痫前期组 Tc1/Tc2值为17.8±3.4,正常对照组为11.8±4.6,两组比较,差异有统计学意义(P<0.001);子痫前期组 Th1/Th2值15.1±2.4,正常对照组为13.2±3.1,两组比较,差异无统计学意义(P>0.05)。结论子痫前期患者底蜕膜组织中母-胎界面的子宫自然杀伤细胞免疫表型无明显变化;但 Tc1/Tc2值向 Tc1偏移,使得母-胎界面 Th1/Th2免疫状态向 Th1型免疫偏移,这一现象可能与子痫前期发病有关。
Objective To investigate the relationship between the immunophenotype of natural killer cells in uterus at maternal-fetal interface and the changes of immune status of Th1 and Th1 and the pathogenesis of preeclampsia. Methods 20 cases of preeclampsia (preeclampsia group) and 11 normal pregnant women (control group) were collected at the time of cesarean section. The decidual tissue of the uterus was collected. The flow cytometry Uterus natural killer cell subsets, uterine natural killer cell surface receptor CD_ (69), CD_ (94) and Th1 / Th2 immune status. Results (1) CD_ (56) ~ (16) ~ - and CD_ (56) ~ (16) ~ ~ subsets of natural killer cells in decidual tissue of preeclampsia (17.3 ± 11.1)% and (16.3 ± 8.7)% respectively in the control group and (17.9 ± 16.8)% and (16.2 ± 8.8)% in the normal control group respectively. There was no significant difference between the two groups (P> 0.05). (2) The content of CD_ (56) ~ + CD_ (69) ~ + and CD_ (56) ~ + CD_ (94) ~ + of uterus decidual tissue in preeclampsia group were (37.9 ± 18.9) % And (34.9 ± 15.2)% in the control group and (36.8 ± 19.7)% and (32.7 ± 16.2)% in the control group respectively. There was no significant difference between the two groups (P> 0.05). (3) The CD_ (56) ~ + CD_ (69) ~ + / CD_ (56) ~ + CD_ (94) ~ + value of preeclampsia group was 1.1 ± 0.2, and the normal control group was 1.2 ± 0.6. The difference was not statistically significant (P> 0.05). (4) The level of cytotoxic T lymphocyte (Tc) 2 in decidua was (3.0 ± 1.0)% in preeclampsia group and (4.3 ± 0.9)% in normal control group, there was statistical difference between the two groups (P <0.001). The Tc1 / Tc2 value in preeclampsia group was 17.8 ± 3.4, and that in normal control group was 11.8 ± 4.6. The difference between the two groups was statistically significant (P <0.001) The Th2 value was 15.1 ± 2.4, and the normal control group was 13.2 ± 3.1. There was no significant difference between the two groups (P> 0.05). Conclusion There is no significant change in the immunophenotype of uterine natural killer cells in the decidua at the end of decidua; however, the value of Tc1 / Tc2 is shifted to Tc1 so that the immune status of Th1 / Th2 at the maternal-fetal interface is Th1 immune Offset, this phenomenon may be related to the pathogenesis of preeclampsia.