原因不明性复发性流产患者Th17／Treg细胞失衡及主动免疫治疗效果

Imbalance of Th17/Treg Cells in Patients with Unexplained Recurrent Spontaneous Abortion and Curative Effect of Lymphocyte Active Im- munotherapy

目的探讨原因不明性复发性流产患者外周血中Th17／Treg细胞水平，及淋巴细胞主动免疫治疗对Th17／Treg平衡的影响。方法应用流式细胞术检测28例原因不明性复发性流产（unexplainedrecurrentspontaneousabortion，URSA）患者和30例正常妊娠早期妇女外周血中Th17／Treg细胞的比例；对自愿接受免疫治疗的23名URSA患者行淋巴细胞主动免疫治疗，检测治疗后患者外周血Th17／Treg水平的变化．并对妊娠结局进行随访。结果URSA患者外周血中Th17细胞比例显著高于对照组，而Treg细胞比例则明显低于对照组，Th17／Treg的比值较对照组升高（P〈0．05）；经主动免疫治疗后，Th17细胞比例下降。Treg细胞比例上升，Th17／Treg比值向Treg细胞方向偏移（P〈0．05）；主动免疫治疗后妊娠成功率为73．9％。结论URSA患者体内存在Th17／Treg细胞平衡失调；通过淋巴细胞主动免疫治疗可改善这一失衡，对UR—SA患者是一种有效的治疗方法。

Objective To investigate the proportions of Th17/Treg in the peripheral blood of patients with unexplained recurrent spontaneous abortion （URSA） and the effect of lymphocyte ac- tive immunotherapy on the balance of Th17/Treg. Methods Flow cytometry was applied to detect the proportion of Th17/Treg in,he peripheral blood of 28 URSA patients （experimental group） and 30 normal early pregnant women （control group） . Then changes in Th17/Treg levels were further assessed in URSA patients who received lymphocyte active immunotherapy. The pregnancy outcomes were followed up. Results The proportion of Th17 cells was significantly higher in URSA group than that in control group, while Treg cell proportion was obviously lower in URSA group （P 〈 0. 05 ） . The ratio of Th17/Treg favored a Th17 shift in URSA group （ P 〈 0. 05 ） . After immuno- therapy, the proportion of Th17 cells decreased while Treg cells increased. The ratio of Th17/Treg was recognized with a Treg shift. Follow up of pregnancy suggested a success rate of 73.9% in the experimental grop. Conclusion There is an imbalance of Th17/Treg in URSA. Lymphocyte active immunotherapy is effective for URSA by improving the imbalance of Th17/Treg.