女性不孕症沙眼衣原体感染与外周血细胞因子Th1和Th2水平相关性

Correlation study on Chlamydia trachomatis infection in female infertility and levels of cytokines secreted by Th1 and Th2 cells in peripheral blood

目的沙眼衣原体是导致女性不孕的一种较为常见病原体,细胞因子在机体免疫防御、组织修复和改建及细胞凋亡中扮演了重要角色。本研究探讨女性不孕症患者沙眼衣原体感染情况及其与外周血细胞因子Th1、Th2表达水平之间的相关性,为女性不孕症的治疗提供理论基础和技术支持。方法选取2015-05-31-2016-12-31郑州市第七人民医院收治的不孕症女性患者55例作为不孕组,选取同期入院体检的55名健康女性作为对照组。采用荧光定量聚合酶链反应法检测两组受试者沙眼衣原体感染情况;采用流式细胞仪检测两组Th1和Th2细胞分泌的特异性细胞因子表达水平。结果不孕组沙眼衣原体感染阳性率为30.91%,高于对照组的7.27%,χ2=8.182,P=0.004。不孕组干扰素-γ(interferon-γ,INF-γ)水平为(13.89±3.14)μg/L,高于对照组的(10.34±2.81)μg/L,t=6.248,P<0.001;不孕组白细胞介素-2(interleukin-2,IL-2)表达水平为(12.61±1.37)μg/L,高于对照组的(9.15±2.78)μg/L,t=8.279,P<0.001;不孕组白细胞介素-4(interleukin-4,IL-4)水平为(1.89±0.96)μg/L,低于对照组的(4.15±0.40)μg/L,t=16.116,P<0.001;不孕组白细胞介素-5(interleukin-5,IL-5)水平为(1.67±0.50)μg/L,低于对照组的(3.68±0.66)μg/L,t=18.003,P<0.001;不孕组白细胞介素-10(interleukin-10,IL-10)表达水平为(5.77±2.06)μg/L,高于对照组的(2.20±0.58)μg/L,t=12.371,P<0.001。Pearson相关分析显示,不孕症与沙眼衣原体感染之间存在相关性,r=0.750,P<0.001;沙眼衣原体阳性率与外周血中INF-γ(r=0.693,P=0.005)、IL-2(r=0.749,P=0.002)、IL-4(r=0.812,P=0.001)、IL-5(r=0.785,P<0.001)和IL-10(r=0.759,P=0.015)显著相关。结论沙眼衣原体感染在女性不孕症患者中阳性率较高,其可能通过影响Th1及Th2细胞分泌细胞因子的表达水平,参与女性不孕症的发生与发展。

OBJECTIVE Chlamydia trachomatis is a common pathogen causing female infertility.Cytokines play an important role in immune defense,tissue repair and remodeling,and cell apoptosis.The purpose of this study is to investigate the relationship between Chlamydia trachomatis infection and the expression of cytokines Th1 and Th2 in peripheral blood of female infertility patients,and to provide theoretical basis and technical support for the treatment of female infertility.METHODS A total of 55 infertile women admitted to Zhengzhou Seventh People’s Hospital from May 31,2015 to December 31,2016 were selected as infertility group,and 55 healthy women admitted to hospital for physical examination at the same time were selected as control group.Fluorescence quantitative polymerase chain reaction was used to detect the infection of Chlamydia trachomatis in the two groups,and flow cytometry was used to detect the expression of specific cytokines secreted by Th1 and Th2 cells.RESULTS The positive rate of Chlamydia trachomatis infection in infertility group was 30.91%,higher than that in control group 7.27%,χ2=8.182,P=0.004.The level of interferon-gamma(INF-gamma)in infertility group was(13.89±3.14)μg/L,higher than that in control group(10.34±2.81)μg/L,t=6.248,P<0.001.The level of interleukin-2(IL-2)expression in infertility group was(12.61±1.37)μg/L,higher than that in control group(9.15±2.78)μg/L,t=8.279,P<0.001.The level of interleukin-4(interleukin-4)in the infertility group was(1.89±0.96)μg/L,lower than that in control group(4.15±0.40)μg/L,t=16.116,P<0.001.The level of interleukin-5(IL-5)in infertility group was(1.67±0.50)μg/L,lower than that in control group(3.68±0.66)μg/L,t=18.003,P<0.001.The expression level of interleukin-10(IL-10)in infertility group was(5.77±2.06)μg/L,higher than that in control group(2.20±0.58)μg/L,t=12.371,P<0.001.Pearson correlation analysis showed that there was a correlation between infertility and Chlamydia trachomatis infection(r=0.750,P<0.001).The positive rate of Chlamydia trachomatis was significantly correlated with INF-gamma(r=0.693,P=0.005),IL-2(r=0.749,P=0.002),IL-4(r=0.812,P=0.001),IL-5(r=0.785,P<0.001)and IL-10(r=0.759,P=0.015)in peripheral blood.CONCLUSIONS There is a higher positive rate of Chlamydia trachomatis infection in female patients with infertility.Chlamydia trachomatis infection maybe participate in the occurrence and development of the female infertility by affecting expression levels of cytokines secreted by Th1 and Th2 cells.