原因不明复发性流产患者外周血及蜕膜组织中CD4^＋CD25^＋调节性T细胞比例的变化

Changes in proportion of decidua and peripheral blood CD4^＋CD25^＋ regulatory T cells in unexplained recurrent spontaneous abortion patients

目的探讨原因不明复发性流产（URSA）患者外周血及蜕膜组织中CD4＋cD夹调节性T（Tr）细胞比例的变化。方法采用双荧光标记流式细胞分析技术检测25例URSA患者（流产组）、34例正常早孕妇女（正常妊娠组）和22例正常非孕妇女（正常非孕组）外周血及蜕膜组织中CD4^＋CD25^＋Tr细胞的比例。结果（1）流产组和正常妊娠组妇女外周血CD4^＋CD25^bright T细胞的比例[分别为（1．55±0．77）％、（2．65±1．10）％]均显著高于正常非孕组妇女[（0．39±0．14）％]，分别比较，差异均有统计学意义（P〈0．05）；流产组妇女外周血CD4^＋CD25^bright T细胞的比例显著低于正常妊娠组妇女，两组比较，差异有统计学意义（P〈0．05）。（2）流产组妇女蜕膜组织中CD4^＋CD25^bright T细胞比例[（0．59±0．23）％]显著低于正常妊娠组妇女[（1．24±0．55）％]，两组比较，差异有统计学意义（P〈0．01）。流产组妇女蜕膜组织中CD4^＋CD25^bright T细胞比例[（4．23±1．52）％]与正常妊娠组[（3．75±1．88）％]比较，差异无统计学意义（P〉0．05）。（3）正常妊娠组妇女蜕膜组织中CD4^＋CD25^bright T细胞占CD4^＋ T细胞的比例（CD4^＋CD25^bright／CD4^＋）为（13．10±10．25）％，显著高于外周血[（5．59±2．62）％]，两者比较，差异有统计学意义（P〈0．05）；流产组患者蜕膜组织中CD4^＋CD25^bright，／CD4^＋比例[（5．16±2．83）％]与外周血[（4．64±2．07）％]比较，差异无统计学意义（P〉0．05）。结论CD4^＋CD25^bright Tr细胞数量在早孕期显著升高，参与了正常妊娠的维持，有可能是调控母．胎界面局部免疫耐受形成的一个重要因素；CD4^＋CD25^bright Tr细胞数量的减少可能与URSA的发生有关。

Objective To study the changes in the percentage of CD4^＋CD25^＋ regulatory T （Tr） cells in peripheral blood and deciduas in unexplained recurrent spontaneous abortion （URSA） patients, normal non-pregnant and pregnant women respectively. Methods The percentage of CD4^＋CD25^＋ Tr cells in deciduas and peripheral blood from 25 URSA patients, 22 normal non-pregnant （NNP） women, and 34 normal early pregnant （NP） women were measured by double-staining followed by flow cytometric analysis. Results ＋ bright （ 1 ） The percentage of CD4^＋CD25^bright T cells in peripheral blood in both URSA and NP [ （ 1.55 ±0. 77 ） %, （2.65 ± 1.10）%, respectively] women were increased significantly than that in NNP women [ （0. 39 ± 0. 14） %, P 〈 0. 05 ] . The percentage of CD4^＋CD25^bright T cells in peripheral blood in URSA women was significantly lower than that in NP women （ P 〈 0. 05 ）. （ 2 ） The percentage of CD4^＋CD25^bright T cells in decidua in URSA women was significantly lower than that in NP women [ （ 0. 59 ± 0. 23 ） %, （ 1.24±0. 55） %, respectively, P 〈 0. 01 ]. There was no significant difference in the percentage of CD4^＋CD25^bright T cells in decidua between URSA women and NP women [ （4. 23 ± 1.52） %, （3.75 ± 1.88） %, respectively, P〉0.05]. （3） The proportion of CD4^＋CD25^bright, CD25 /CD4 cells in deciduas was significantly higher than that in peripheral blood in NP women [ （ 13.10 ± 10. 25 ） % , （ 5.59 ± 2. 62 ） % , respectively, P 〈 0. 05 ] . However, a significant difference in the proportion of CD4^＋CD25^bright/CD4 between decidua and peripheral blood was not found in URSA patients [ （ 5.16 ± 2. 83 ） %, （ 4. 64 ± 2.07 ） % , respectively, P 〉 0. 05 ） ]. Conclusions The number of CD4^＋CD25^＋ Tr cells is increased in normal pregnancy and decreased in URSA. Therefore,CD4^＋CD25^＋ Tr cells may play an important role in maintaining maternal-fetal tolerance and may be involved in the pathogenesis of URSA.