外周血CD4^+T细胞凋亡率对妊娠期高血压疾病眼底病变的影响

The effect of the rate of apoptosis of CD4^+T cell in peripheral blood on retinopathy in pregnancy-induced hypertension(PIH)

目的:探讨妊娠期高血压疾病(PIH)患者外周血CD4+T细胞凋亡率对眼底病变的影响。方法:采用流式细胞技术检测40例住院PIH患者(轻、中、重组)和20例正常妊娠待产产妇产前和产后静脉血中凋亡的CD4+T细胞率及表面表达Fas(CD95)的CD4+T细胞率,对比分析4组率的差别、相关性及对眼底病变影响。结果:产前4组之间凋亡的和表达Fas的CD4+T细胞率差异有统计学意义,分别为P<0.05和P<0.01,正常组、中度组和重度组各与轻度组差异有统计学意义;产后4组凋亡的CD4+T细胞率差异无统计学意义;产前和产后4组凋亡的和表达Fas的CD4+T细胞率相关性没有统计学意义。产前和产后眼底病变0、Ⅰ、Ⅱ、Ⅲ级4组之间及眼底正常组和病变组两组之间凋亡的CD4+T细胞率差异无统计学意义;眼底病变分级与妊娠高血压程度之间有明显相关性(P<0.01)。结论:PIH患者眼底改变有随临床病情加重而加重趋势,产后PIH患者眼底病变情况比产前普遍好转;外周血CD4+T细胞凋亡对PIH的发生发展有一定的预警意义,虽然Fas/FasL途径参与了这个过程,但是此时它不是凋亡的主要途径,还有其它凋亡途径的参与;尚不能肯定外周血CD4+T细胞凋亡在PIH视网膜病变发生发展过程中的作用。

Objective：To observe the effect of the rate of apoptosis of CD4＋T cell in peripheral blood on retinopathy in PIH.Methods：The rates of CD4＋T cells which had been in the status of apoptosis and which expressed Fas were detected by flow cytometry in peripheral blood of 40 cases of women with PIH（divided into three groups by extent of disease）and 20 cases of women with normal pregnancy before and after delivery. The rates were compared,the correlation between them and effect on retinopathy were discussed.Results：There were apparent statistical significance among the four groups before delivery （P0.05,P0.01）. The minor group had conspicuous statistical significance compared with any of other three groups; there was no statistical significance with respect to the rate of apoptosis after delivery; there wasn＇t transparent correlation between two rates before and after delivery. The rates of apoptosis had no statistical significance among four groups（divided by extent of retinopathy）and between two groups（divided by whether retinopathy or not）. There were conspicuous relationship between the extent of retinopathy and the disease,P0.01.Conclusion：Retinopathy of PIH positively correlate with the extent of clinical condition.The apoptosis of CD4＋T cell in peripheral blood plays an alarming role in the pathogenesis of PIH.Other leading ways may contribute to it,though it is mediated by Fas/FasL pathway. Role of the rate of apoptosis of CD4FT cell in peripheral blood in PIH needs to be further discussed when referred to retinopathy.