妊娠合并重症甲型H1N1流感患者T细胞亚群及Th1／Th2水平的变化

Changes of T-Cell Subsets and Thl/Th2 Levels in Pregnant Women with Severe Influenza A（ H1N1 ）

[目的]研究妊娠合并重症甲型H1N1流感患者T细胞亚群的分布特点及辅助性T细胞1/辅助性T细胞2（Th1/Th2）水平的变化.[方法]收集2009年11月14日至12月31日于中国医科大学附属盛京医院确诊的女性甲型H1N1流感患者34例,按是否妊娠分为甲流妊娠组（A组,17例）,甲流非妊娠组（B组,17例）,同时收集抗H1N1抗体阳性的健康妊娠女性作为妊娠对照组（C组,15例）,通过流式细胞仪检测CD4＋、CD8＋ T细胞亚群的百分比,采用ELISA法检测各组血清干扰素-γ（INF-γ）,白细胞介素-4（IL-4）及白细胞介素-10（IL-10）浓度.[结果]A组CD8＋T细胞百分比中位数为35%（22%～40%）,显著高于B组的29.5%（14%～32%）;A组CD4＋ T细胞百分比中位数为35%（19%～43%）,CD4＋/CD8＋比值为1.054（0.49～1.77）,均分别显著低于B组[45%（35%～54%）和1.535（1.27～3.14）],其差异有显著性（均P〈0.05）.与B组比较,A组IL-10显著增高（P〈0.05）.与C组比较,A组和B组IFN-γ及IL-10均显著增高（均P〈0.05）.[结论]妊娠合并重症甲型H1N1流感患者可出现暂时性的免疫缺陷。

[Objective] To study the distribution of T cell subsets and the level of Thl/Th2 cytokines inpregnant women with severe influenza A（H1N1）. [Methods]Thirty four female patients diagnosed as H1N1 virus infection during Nov. 14 to Dec. 31, 2009 were divided into pregnant patients with influenza（Group A, n =17） and non-pregnant patients with influenza（Group B, n = 17）. Another group of healthy pregnant female who had a positive anti-HIN1 IgG served as a control group（Group C, n =15）. The percentage of CD4^＋ and CD8^＋ T-cell subsets was determined by using flow cytometry. Enzyme-linked immunosorbnent assay （ELISA） was used to examine serum interferon-gamma （IFN-7）, interleukin-4 （IL-4） and interleukin-10 （ IL- l0） levels. [Results] The median percentage of CD8^＋ T-cell in group A was 35 % （22%-40%） which was sig nificantly higher than that in group B[29.5% （14 %-32% ）1 （ P 〈0.05）. The median percentage of CD4^＋ Tcell and CD4^＋/CD8^＋ in group A was 35%（19%-43%） and 1. 054（0.49-1.77）, respectively, which were lower than those in group B[45%（35%-54%） and 1. 535（1.27-3.14）], and there was significant difference （all P 〈0.05）. Compared with group B, IL 10 level in group A increased significantly（ P %0.05）. Compared with group C, IFN-7 and IL 10 levels in group A and group B increased significantly（all P〈0. 05）. [Conclusion] Temporary immunodeficiency may be found in pregnant women with severe influenza A（HIN1）. The immune pathological damage caused by influenza A（HIN1） may be attributed to the increased Thl/Th2 cytokines.