CD4^+Foxp3^+调节性T细胞在不足月胎膜早破患者外周血中的表达及意义

Expression of CD4^+Foxp3^+Regulatory T Cells in Peripheral Blood of Patients with Premature Premature Rupture of Membrane

目的:检测不足月胎膜早破(pPROM)患者外周血中CD4+Foxp3+调节性T细胞的表达,探讨其在pPROM早产中的作用及意义。方法:选取2013年9月至2014年1月在中国医科大学附属盛京医院住院病例及门诊正常体检病例共60例,其中pPROM患者(孕34~36周)30例(pPROM组),正常妊娠对照组30例(孕34~36周)。采每位受试对象抗凝外周血5 ml,分离外周血单个核细胞。使用流式细胞术检测外周血中CD4+Foxp3+调节性T细胞的表达。结果:pPROM组与正常妊娠对照组相比,外周血中CD4+Foxp3+调节性T细胞占CD4+T细胞的比例降低,差异有统计学意义(P=0.0093);pPROM组中分娩发动≥48小时者CD4+Foxp3+调节性T细胞占CD4+T细胞的比例高于分娩发动的时间<48小时者(P=0.0246);pPROM组中Apgar评分>7分者和≤7分者CD4+Foxp3+调节性T细胞占CD4+T细胞的比例差异无统计学意义(P>0.05)。结论:pPROM患者外周血中CD4+Foxp3+调节性T细胞的表达降低,参与pPROM的发病。pPROM患者CD4+Foxp3+调节性T细胞的表达高低与分娩发动时间有关,而与新生儿出生Apgar评分无明显关系。

Objective：To examine the expression of CD4＋ FOXP3＋regulatory T cells in peripheral blood of patients with premature premature rupture of membrane （ pPROM）, and explore its role in the pathogenesis of pPROM. Methods ：30 patients with premature rupture of membranes （34-36 pregnancy weeks, pPROM group） and 30 cases with normal pregnancy（34-36 pregnancy weeks, control group） from september 2013 to January 2014 in shengjing hospital were enrolled in this study. 5 ml fresh peripheral venous blood was obtained from 60 subjects,and the expression of CD4＋Foxp3＋regulatory T cells was examined by flow cytometry. Results.The percentage of CD4 ＋ Foxp3＋ regulatory T cells in CD4 ＋T cells in pPROM groups was significantly lower than that in control group（ P =0.0093）. In the pPROM group,the percentage of CD4＋Foxp3 ＋ regulatory T cells in CD4＋T cells in those with the duration of labor onset ≧48 h was significantly higher than those with the duration 〈48h （ P = 0.0246 ）. There was no significant difference in the percentage of CD4 ＋ Foxp3 ＋ regulatory T cells between the patients with Apgar score 〉 7 and those with Apgar score ≦7 （P 〉0.05）, Conclusions; The expression of CD4 ＋ Foxp3 ＋regulatory T cells decreased in pPROM patients,but is not correlated with the Apgar score of newborn. Lack of CD4 ＋ Foxp3 ＊ regulatory T cells may play a role in the pathogenesis of PROM,and the labor onset.