不明原因复发性自然流产外周血自然杀伤细胞亚群检测的临床意义

The clinical significance of detecting peripheral blood natural killer cell in the unexplained recurrent spontaneous abortion

目的：分析复发性自然流产（RSA）患者外周血自然杀伤（NK）细胞亚群百分比，为不明原因复发性自然流产（URSA）的诊断及治疗提供相关的科学依据。方法将63例 RSA 患者分为 RSA 有明确原因组（CRSA）33例和 URSA 30例，选择同期30名正常早孕者为对照组。采用流式细胞仪检测RSA 患者外周血自然杀伤（NK）细胞水平及其亚群百分比并与正常早孕组作对照。结果33例 CRSA外周血 NK 细胞（13.77±1.53）％、30例 URSA 外周血 NK 细胞（13.97±1.60）％、30名正常早孕组外周血 NK 细胞（13.65±1.74）％，3组比较差异无统计学意义（F =0.287，P 〉0.05）；CRSA 外周血 NK 细胞亚群 CD56＋ CD16-、CD56＋ CD16＋、CD56- CD16＋百分比分别为（70.00±2.49）％、（13.76±2.13）％、（7.04±1.44）％；URSA 外周血 NK 细胞亚群 CD56＋ CD16-、CD56＋ CD16＋、CD56- CD16＋百分比分别为（56.50±3.94）％、（22.88±3.22）％、（11.24±2.21）％；正常早孕外周血 NK 细胞亚群 CD56＋ CD16-、CD56＋ CD16＋、CD56- CD16＋百分比分别为（70.48±3.21）％、（14.16±2.14）％、（6.53±1.98）％。URSA 与 CRSA、正常早孕比较差异均有统计学意义（F 值分别为182.587、18.118、58.879，P 均〈0.01）， CRSA 与正常早孕比较差异无统计学意义（P 〉0.05）。结论 NK 细胞活性功能在 URSA 中起关键作用。检查 NK 细胞亚群百分比有助于有 RSA 妇女孕期监测；NK 细胞亚群百分比变化能预测妊娠结局。

Objective To investigate the change of peripheral blooe natural killer（NK）cell subsets of patients with recurrent spontaneous abortion（ RSA）,in oreer to proviee the relevant scientific evieence for unexplainee recurrent spontaneous abortion（ URSA） eiagnosis ane treatment. Methods Sixty-three RSA patients were raneomly eivieee into CRSA（n = 33）ane URSA（n = 30）. Meanwhile 30 cases normal pregnancy women were selectee as control. Flow cytometry was appliee to eetect NK cell levels in patients with RSA ane its subsets percentage,ane then comparee to the control group. Results NK cells subset in RSA,URAS ane normal pregnancy women were（13. 77 ± 1. 53）% ,（13. 97 ± 1. 60）% ,ane（13. 65 ± 1. 74）%. There was no significant eifference among three groups（ F = 0. 287,P 〉 0. 05）. The percent of CD56 ＋ CD16 - ,CD56 ＋CD16 ＋ ,CD56 - CD16 ＋ NK cell subsets in RAS group were：（70. 00 ± 2. 49）% ,（13. 76 ± 2. 13）% ,（7. 04 ± 1. 44）% respectively,ane（56. 50 ± 3. 94）% ,（22. 88 ± 3. 22）% ,（11. 24 ± 2. 21）% in URAS group, meanwhile（70. 48 ± 3. 21）% ,（14. 16 ± 2. 14）% ,（6. 53 ± 1. 98）% in normal pregnancy group. There was no significant eifference between RSA ane normal pregnancy group（ P 〉 0. 05）. However,There was markeely eifference between URSA with RSA or normal group（F = 182. 587,18. 118,58. 879,P 〈 0. 05）. Conclusion NK cell activity function plays a key role in the eevelopment of URSA. The eetection of the percentage of NK cell subsets of women euring pregnancy will help RSA monitoring ane NK cell subsets can preeict the percentage change in the pregnancy outcome .