弓形虫先天感染与妊娠结局及脐带血T淋巴细胞亚群构成的关系

The relationship among congenital Toxoplasma gondii infection, pregnancy outcome and T lymphocyte subsets in umbilical cord blood

目的探讨弓形虫先天感染与脐带血T淋巴细胞亚群构成及妊娠结局的关系。方法2009年3月至2010年5月于合肥市某医院采集784份新生儿脐带血标本，并收集所有新生儿的妊娠结局资料。应用ELISA检测血清弓形虫IgM抗体，对抗体阳性者和10名健康新生儿采用流式细胞术检测脐带血中的T淋巴细胞亚群构成。结果根据弓形虫IgM抗体检测结果，将784名新生儿中分为感染组（21例）和对照组（763名）。感染组体重及1minApgar评分分别为（3116．4±352．6）g、（8．21±1．26）分，低于对照组的（3220．1±242．3）g、（8．77±1．61）分，差异有统计学意义（P值均〈0．01）。感染组中不良妊娠结局占19，O％（4／21），高于对照组的4．8％（37／763），差异有统计学意义（P=0．004）。感染组中伴或不伴不良妊娠结局的新生儿，其脐带血CD3^＋T淋巴细胞比例分别为（64．51±5．27）％、（64．32±4．56）％，低于健康新生儿的（69．92±4．32）％（P值均〈0．01）；其脐带血CD4^＋／CD8^＋分别为1．39±0．24、1．64±0．28，低于健康新生儿的2．34±0．46（P值均〈0．01）。结论弓形虫感染可导致新生儿不良妊娠结局和细胞免疫功能紊乱，妊娠结局与T淋巴细胞亚群构成有关。

Objective To reveal the relationship among congenital Toxoplasma gondii （T. gondii） infection, T lymphocyte cell subsets in umbilical cord blood and pregnancy outcome. Methods 784 umbilical cord blood samples were collected and information of pregnancy outcomes was collected in a hospital of Hefei city,Anhui province during March 2009 to May 2010. T. gondii IgM antibodies in the sera were detected by ELISA. For all neonates infected with T. gondii and 10 healthy neonates,T lymphocyte cell subsets were detected by flow cytometry. Results According to the detection results of T. gondii IgM antibodies, 784 neonates were divided into infection group （21 neonates） and control group（763 neonates）. The body weight and 1 min Apgar score of infection group were （ 3116. 4 ± 352.6） g and （ 8. 21 ± 1.26 ） points, respectively, which were statistically lower than control group （ （ 3220. 1 ± 242. 3 ） g and （ 8.77 ±1.61 ） points, respectively） （ P 〈 0. 01 ）. The proportion of adverse pregnancy outcome of infection group was 19. 0% （ 4/21 ）, which was statistically greater than control group （ 4. 8%, 37/763 ） （ P 〈 0. 01 ）. The percentage of CD3^＋ T lymphocyte ceils in umbilical cord blood in infection group with and without adverse pregnancy outcomes were （64. 51 ± 5.27） % and （64. 32 ±4. 56） %, respectively, which were statistically lower than control group（ （69. 32 ± 4. 32 ）% ） （P 〈 0. 01 ）. The ratio value of CD4/CDs in infection group with, without adverse pregnancy outcomes and control group are 1.39 ± 0. 24,1.64 ± 0. 28 and 2. 34 ± 0. 46, respectively, which showed statistical difference between any 2 groups （ P 〈 0. 01 ）. Conclusion T. gondii infection leads to adverse pregnancy outcomes and disorder of cellular immunity while T lymphocyte cell subsets are closely associated with adverse pregnancy outcome.