外周血雌二醇水平和CD4^+CD25^+Treg细胞与反复自然流产相关性研究

The role of peripheral blood oestradiol and CD4^+ CD25^+ Treg cells in recurrent spontaneous abortion

目的探讨外周血雌二醇水平和CD4^+CD25^+Treg细胞在反复自然流产发病机制中的作用。方法采用电化学发光法检测30例反复自然流产患者,90例正常妊娠女性(早、中、晚孕女性各30例)以及30例正常非孕女性外周血雌二醇水平;三色流式细胞术检测上述研究对象外周血CD4^+CD25^+Treg细胞数量。结果早、中、晚孕组外周血雌二醇水平均明显高于非妊娠对照组(t值分别为7.42,1 3.66,14.69;均P<0.05),并且孕周越长雌二醇水平越高;反复自然流产组明显低于正常非妊娠组(t=4.11,P<0.05)。早、中、晚孕组外周血CD4^+CD25^+Treg细胞数均明显高于正常非妊娠组(t值分别为2.22、8.9、5.91,均P<0.05),中孕组明显高于早孕组(t=6.31,P<0.05),晚孕组略低于中孕组,但差异无统计学意义;反复自然流产组明显低于正常非妊娠组(t=8.07,P<0.05)。结论外周血雌二醇水平和CD4^+CD25^+Treg细胞数量减低可能下调母胎免疫耐受功能,参与介导反复自然流产的发生。

Objective To investigate the role of peripheral blood oestradiol and CD4^＋ CD25^＋ Treg cells in the pathogenesis of recurrent spontaneous abortion （RSA）. Methods Electrochemiluminescence assay was adopted to measure peripheral blood level of oestradiol and tri-color flow cytometry was applied to counting CD4^＋ CD25^＋ Treg cells in 30 patients with RSA （RSA group）, 30 women of non-pregnancy （nompregnancy group）, and 90 normal pregnant women （early pregnancy, mid-preg nancy and late pregnancy, 30 women for each group）. Peripheral blood level of oestradiol was detected by electrochemistry immunoluminescence technology for all subjects. Results Compared with that in non pregnancy group, peripheral blood level of oestradiol was significantly higher in goups of early pregnancy, mid-pregnancy and late pregnancy （t value was respectively 7.42, 13.66 and 14.69; all P 〈0.05） ; moreover, the longer gestational week was, the higher was the level of oestradiol. However, the oestradiol level of RSA group was markedly lower than that of non-pregnancy group（t=4.11, P〈0. 05）. The number of CD4^＋ CD25^＋ Treg of normal pregnancy women （early pregnancy, midpregnancy and late pregnancy） was higher than that of non gestation women obviously. The number of CD4^＋ CD25^＋ Treg was at peak in mid pregnancy. The number of CD4^＋ CD25^＋ Treg was obviously lower in RSA group than that in non-pregnancy group （t=8.07,P〈0.05）. Conclusion Reduced peripheral blood level of oestradiol and CD4^＋ CD25^＋ Treg may down-regulate the immune function of maternal fetal tolerance, and mediate recurrent spontaneous abortion finally.