原因不明复发性流产患者外周血中Thl/Th2型细胞因子水平的研究

Study on the Serum Levels of Th1/Th2 Cytokines of Patients with Unexplained Recurrent Spontaneous Abortion

目的:探讨原因不明复发性流产(URSA)患者再次妊娠时不同妊娠结局与外周血中Th1/Th2型细胞因子水平的变化规律。方法:采用酶联免疫吸附法检测:①33例URSA患者、32例正常妊娠及78例正常未孕妇女外周血IL-2、IL-10、IFN-γ、IL-4、IL-6的水平;②回顾性分析23例URSA患者再次正常妊娠前、后外周血IL-2、IL-10、IFN-γ、IL-4、IL-6水平的变化;③URSA患者随访中,44例再次正常妊娠与16例妊娠后再次流产的外周血IL-2、IL-10、IFN-γ、IL-4、IL-6水平的比较。结果:①与正常妊娠组及正常未孕组相比,URSA组外周血中Th1型细胞因子IL-2、IFN-γ的水平升高(P<0.05),Th2型细胞因子IL-10、IL-4、IL-6的水平降低(P<0.05);②URSA患者再次正常妊娠前、后自身对照比较结果显示,Th1型细胞因子IL-2、IFN-γ外周血水平在同一URSA患者妊娠阶段有明显下降(P<0.05),而Th2型细胞因子IL-4则有明显上升(P<0.05);③在URSA患者再次妊娠后,再次流产组Th1型细胞因子IL-2、IFN-γ外周血水平较继续妊娠组高(P<0.05),Th2型细胞因子IL-10、IL-4外周血水平较继续妊娠组低(P<0.05)。结论:URSA患者Th1型细胞因子升高,Th2型细胞因子降低,而URSA患者再次正常妊娠时Th1型细胞因子降低,Th2型细胞因子升高。外周血中Th1/Th2细胞因子的变化与妊娠结局相关。

Objective： To investigate the serum levels of Thl/Th2 cytokines of patients with unexplained recurrent spontaneous abortion （URSA）, and the variation of different pregnancy outcomes. Methods： Enzyme- linked immunosorbent assay was used to detect serum levels of Thl/Th2 cytokines： 1） the serum levels of IL-2, IL-10, IFN-T, IL-4, IL-6 in URSA group （n=33）, normal pregnancy group （n=32） and normal unpregnancy group （n=78）; 2） the serum levels of IL-2, IL-10, IFN-T, IL-4, IL-6 in URSA patients with normal pregnancy group; 3） the serum levels of IL-2, IL-10, IFN-Y, lL-4, IL-6 of URSA patients with different pregnancy results. Results： 1） Compared with normal pregnancy group and normal unpregnancy group, the serum levels of IL-2, IFN-T ofURSA group were significantly higher （P〈0.05）. The serum levels of IL-10, IL-4 and IL-6 of URSA group were slightly lower （P〈0.05）. 2） URSA patients with normal pregnancy paired comparison results indicated that the serum levels of IL-2 and IFN-T of the stage of pregnancy decreased significantly （P〈0.05）, the serum levels of IL-4 was significantly increased （P〈0.05）. 3） URSA patients with different pregnancy outcomes showed that the serum levels of IL-2 and IFN-T of normal pregnancy group were significantly lower than those of the abortion group （P〈0.05）. The serum levels of IL-10 and IL-4 of normal pregnancy group were slightly higher （P〈0.05）. Conclusion： In patients with URSA, Thl type cytokines elevated, Th2 type cytokines decreased, and when URSA patients got normally pregnant again, Thl cytokines decreased, Th2 type cytokine increased. The change of Thl/ Th2 cytokines in peripheral blood is related to pregnancy outcome.