不明原因反复自然流产患者免疫治疗前后外周血CD4^+CD25^+CD127^(low)T细胞百分率的分析

Percentages of peripheral blood CD4^+CD25^+CD127^(low) T cells before and after the treatment of paternal lymphocyte induced immunization in patients with unexplained recurrent spontaneous abortion

目的探讨不明原因反复自然流产(URSA)患者外周血调节性T细胞(Treg)中CD4^+CD25^+CD127^(low)T细胞的表达情况及经配偶淋巴细胞免疫治疗后的妊娠结局改变,判断其作为流产指标的可能性。方法用流式细胞术检测73例URSA患者治疗前、76例正常早孕者(正常早孕组)及69名正常未孕体检者(正常未孕组)外周血中CD4^+CD25^+CD127^(low)T细胞百分率,分析经配偶淋巴细胞免疫方法治疗2~3个疗程后的51例URSA患者外周血CD4^+CD25^+CD127^(low)T细胞百分率的变化情况。结果 URSA组治疗前外周血CD4^+CD25^+CD127^(low)T细胞百分率(2.73%±0.56%)明显低于正常未孕组(2.93%±0.60%)和正常早孕组(4.36%±1.07%)(P<0.05)。51例URSA患者治疗后外周血CD4^+CD25^+CD127^(low)T细胞百分率(3.72%±1.15%)明显高于治疗前(P<0.05),其中42例患者治疗后妊娠结局较好,有9例失败。结论 URSA患者外周血CD4^+CD25^+CD127^(low)T细胞表达明显降低,其有可能作为判断URSA的指标之一。体外配偶淋巴细胞免疫治疗与妊娠结局改善有关。

Objective To investigate the expression of peripheral blood CD4＋CD25＋CD127low T cells in regulatory T cells （ Treg ） of patients with unexplained recurrent spontaneous abortion （ URSA ） , to analyze the percentages before and after the treatment of paternal lymphocyte induced immunization, and to evaluate its probability as a diagnosis indicator for abortion. Methods By flow cytometry, the percentages of peripheral blood CD4＋CD25＋CD127low T cells were determined in 73 patients with URSA before the treatment, 76 healthy women with early pregnancy and 69 healthy women without pregnancy. A total of 51 patients with URSA underwent the treatment of paternal lymphocyte induced immunization for 2-3 treatment courses. Their percentages were determined as well. Results Before the treatment, the percentage of CD4＋CD25＋CD127low T cells in URSA group （2.73%±0.56% ） was lower than those in healthy pregnancy and non-pregnancy groups （ 4.36%±1.07% and 2.93% ±0.60%）（P〈0.05 ） . After the treatment, the percentage （ 3.72% ±1.15% ） was higher than that before the treatment （P〈0.05 ） . The pregnancy outcome of 42 patients after the treatment was good, while the treatment for the other 9 patients failed. Conclusions The percentage of peripheral blood CD4＋CD25＋CD127low T cells in URSA patients is lower than those in healthy pregnant and non-pregnant women, which can be as a diagnosis indicator for URSA, and it can be improved by the treatment of paternal lymphocyte induced immunization.