流产患者外周血肿瘤坏死因子可溶性白细胞介素-2受体及T淋巴细胞亚群的测定

Detection of tumor necrosis factor alpha, soluble interleukin-2 receptor and T lymphocyte subsets of peripheral blood in patients suffering from spontaneous abortion.

对８５例早期流产患者采用酶联免疫吸附法测定外周血肿瘤坏死因子（ＴＮＦ－α）、可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）以及采用流式细胞仪检测外周血Ｔ淋巴细胞亚群（总Ｔ淋巴细胞，ＣＤ３；Ｔ辅助，ＣＤ４；Ｔ抑制，ＣＤ８）。流产患者分为三组：２５例难免或不全流产（ＥＡ），先兆流产２０例治疗失败（ＴＡＦ）及３８例治疗成功（ＴＡＳ）。选择正常早孕妇女（ＮＰ）及非孕妇女（ＮＮＰ）各２０例为对照。结果：①血清ＴＮＦ－α、ｓＩＬ－２Ｒ水平在ＥＡ、ＴＡＦ、ＴＡＳ组分别明显高于ＮＰ组（Ｐ＜０．０５），且在ＥＡ、ＴＡＦ组较ＴＡＳ组明显升高（Ｐ＜０．０５）。血清ＴＮＦ－α、ｓＩＬ－２Ｒ水平在ＮＰ组与ＮＮＰ组没有明显差异（Ｐ＞０．０５）。②ＣＤ８细胞在ＥＡ、ＴＡＦ组分别明显低于ＴＡＳ、ＮＰ组（Ｐ＜０．０５），ＣＤ３、ＣＤ４在各组没有明显差异（Ｐ＞０．０５）。提示：自然流产可能与机体免疫异常有关。

Objective: To study the correlation between spontaneous abortion and immunoreaction. Design: Eighty-five patients with pregnancy between 6th and 12th weeks were hospitalized for spontaneous abortion. They were divided into three groups according to their clinical manifestations. Group EA (embryo abortion, n=25) had incomplete or inevitable abortion. Group TAF (n=20) had threatened abortion which did not respond (fail) to the treatment. Group TAS (n=38) had threatened abortion which was successfully treated. Twenty normal women in their first trimester of pregnancy was selected as one control group (NP) and the other control group (NNP) consisted of 20 non-pregnant women. Serum levels of TNF-α and sIL-2R were measured by enzyme-linked immunoassay and T lymphocyte subsets (CD 3,CD 4,CD 8) of peripheral blood were analysed with flow cytometry. Results: Both levels of TNF-α and sIL-2R were increased in EA, TAF and TAS groups as compared with NP group (P<0.05), and the levels in EA and TAF groups were higher than those in TAS group (P<0.05). No significant difference was found between NNP group and NP group. T lymphocyte subset analysis showed that percentages of CD 8 in EA and TAF groups were significantly lower than those of TAS and NP groups, respectively (P< 0 05). The ratios of CD 4/CD 8 in EA and TAF groups were increased as compared with TAS and NP groups, respectively (P<0.05). There was no difference in percentage of CD 3 and CD 4 cells among all groups. Conclusions: Immunologic abnormalities may be associated with spontaneous abortion. \ \