甲状腺过氧化物酶抗体阳性的复发性流产患者外周血T细胞亚群的分析

Analysis of T cell subgroup in peripheral blood of recurrent spontaneous abortion patients with thyroid peroxidase antibody positive

目的观察甲状腺过氧化物酶抗体(TPOAb)阳性的复发性流产(RSA)患者外周血T细胞分化情况及Th1和Th2细胞的效应细胞因子IFN-γ和IL-4在基因转录水平的表达,初步探索TPOAb阳性(TPOAb+)的RSA患者机体的免疫状态。方法依据TPOAb结果将RSA的患者分为TPOAb+的RSA患者和其他原因RSA患者。用流式细胞术检测外周血T细胞亚群分布,用RT-PCR技术检测IFN-γmRNA和IL-4 mRNA。结果分别与正常对照组和其他原因的RSA组相比,TPOAb阳性的RSA组患者CD3^+T细胞、CD4+T细胞百分比及CD4/CD8比例显著升高(P<0.05);TPOAb+的RSA组患者IFN-γmRNA表达量显著上调,IL-4 mRNA的表达量则显著下调,差异均有统计学意义(P<0.05)。结论 TPOAb阳性的RSA患者外周血T淋巴细胞亚群分化失调,CD4^+T细胞分化增多,免疫功能状态过度,并且其Th细胞在分化成Th1和Th2过程中存在向Th1方向分化偏移和极化的Th1/Th2失衡。

Objective Through observing the differentiation of T cell in peripheral blood of recurrent spontaneous abortion pa- tients with thyroid peroxidase antibody positive and the transcriptional levels of IFN -γand IL- 4 in Thl and Th2 cytokines, to explore the immunity of RSA patients with TPOAb ＋. Methods According to the results of TPOAb, RSA patients were divided into two groups ： TPOAb ＋ RSA group and other reasons RSA group. The distributions of T cell subtype in peripheral blood were detected by flow cytometry. The mRNA expression levels of IFN - γ and IL - 4 were tested by RT - PCR. Results Compared to the normal control group and the RSA patients group with other reasons respectively, in RSA patients group with TPOAb posi- tive, the percentage of CD3 ＋ and CD4＋ T cell and the ratio of CD4＋/CD8 significantly increased（P 〈 0. 05）. The mRNA ex- pression level of IFN - ~/mRNA was significantly up - regulated in TPOAb ＋ group, while the mRNA expression level of IL - 4 was significantly down- regulated, with the differences statistically significant（P 〈 0.05）. Conclusion Differentiation disorder existed in T cell subtypes in peripheral blood of RSA patients with TPOAb ＋. The quantity of CD4＋ T cells increased and the im- mune status overreacted. During the differentiation, Th cells showed polarized Th1/Th2 imbalance and the tendency to Th1.