重度子痫前期孕妇外周血免疫细胞变化情况及意义

Changes and significance of peripheral immune cells in pregnant women with severe preeclampsia

目的探讨重度子痫前期孕妇外周血免疫细胞的病理迁移特征及其对母婴结局的影响。方法选取本院收治的31例重度子痫前期孕妇为观察组,并以同期入院的31例健康孕妇为对照组,进行血清免疫学对照研究;分别抽取2组患者的空腹静脉血,采用流式细胞仪检测辅助性、抑制性、调节性T细胞计数,并采用ELISA试剂盒测定相关细胞因子水平,同时采用全自动生化分析仪测定母体肝功能指标ALT、AST、Cr及肾功能指标BUN、UA、URO的血清含量;结合分娩孕周及新生儿体质量分析重度子痫前期外周血免疫细胞的病理迁移过程。结果观察组的Th1、Th17细胞计数及相应细胞因子分泌水平显著高于对照组(P<0.05),Th2、Ts、Treg细胞计数相应细胞因子分泌水平显著低于对照组(P<0.05);观察组母体肝功能指标ALT、AST、Cr及肾功能指标BUN、UA、URO均显著高于对照组(P<0.05),分娩孕周、新生儿体质量均显著小于或低于对照组(P<0.05)。结论重度子痫前期孕妇外周血存在调节性T细胞相对抑制,抑制性T细胞向辅助性T细胞迁移及辅助性T细胞比例失调三大病理特征,长期的免疫功能亢进可能是母体发生免疫排异和肝肾损伤的重要机制之一。

Preeclampsia is a peculiar disease for gravida which could cause both maternal and perinatal death. In the last few years, immune function defect has been thought of playing an important role in the pathogenesis and etiology of preeclampsia with T-cell immunity imbalance as a special concern. In this study, we aim to explore the pathological migration characteristics of T immune cells in severe preeclampsia as well as its effect on maternal- fetal outcome. Total of 31 cases of severe preeelampsia patients and 31 cases of healthy pregnant women were selected and studied comparatively, whose fasting blood were extracted to detect both the T-lymphocyte subsets＇ cell count and their adipokines lever on basis of each subset activity was assessed; furthermore, we also determined maternal hepatorenal function and neonates birth conditions. We found that Thl and Th17 cell count as well as their cytokine secretion levels of observation group were both significantly higher than those of control group （P 〈 0.05）, while Th2, Ts, Treg cells counts and corresponding cytokine secretion levels got crosscurrent （P〈 0.05）; at the same time, maternal liver function indexes of ALT, AST, Cr and kidney function indexes of BUN, UA, URO of observation group were all significantly higher than those of control group （P〈 0.05）; also, neonates birth gestational age and weight were significantly lower than those of control group （P 〈 0.05）. Our research results indicate that there are pathological changes in severe preeclampsia patients which presenting imbalance of Th1, Th2, Th17 and Treg, which may impair maternal hepatorenal function and contribute to premature delivery.