自身免疫在复发性流产中的表达

Expression of Autoimmunity in Recurrent Abortion

目的研究复发性流产(RSA)患者外周血自身免疫抗体、淋巴细胞亚群及血清维生素D水平表达及其临床意义。方法选取2015年2月—2018年5月来我院就诊的RSA保胎患者500例作为RSA组,另选取同期我院体检健康的孕妇500例作为对照组,比较两组受试者外周血自身免疫抗体、淋巴细胞亚群及血清维生素D水平。结果 RSA组抗心磷脂抗体检出率21.8%、抗核抗体检出率20.4%、抗甲状腺过氧化物酶抗体检出率27.2%、抗子宫内膜抗体检出率19.0%、抗精子抗体检出率15.4%、抗绒毛膜促性腺激素抗体检出率13.6%、CD4^+/CD8^+比值(1.58±0.26)均高于正常孕妇组,差异均具有统计学意义(P <0.05);CD4^+CD25^+Tr含量(10.82±2.13),25(OH)D含量(17.84±2.23)ng/mL均低于正常孕妇组,差异均具有统计学意义(P <0.05)。结论自身免疫反应、CD4^+/CD8^+比值升高,CD4^+CD25^+Tr、维生素D水平不足可能是导致复发性流产的危险因素。

Objective To study the expression of autoimmune antibodies, lymphocyte subsets and serum vitamin D in patients with recurrent spontaneous abortion (RSA) and its clinical significance.Methods 500 cases of RSA fetus-preserving patients who came to our hospital from February 2015 to May 2018 were selected as RSA group.Another 500 healthy pregnant women in our hospital during the same period were selected as control group.The levels of peripheral blood autoimmune antibodies,lymphocyte subsets and serum vitamin D were compared between the two groups.Results The detection rates of anti-cardiolipin antibody,anti-nuclear antibody,anti-thyroid peroxidase antibody,antiendometrial antibody,anti-sperm antibody,anti-chorionic gonadotropin antibody and CD4^+/CD8^+ ratio in RSA group were 21.8%,20.4%,27.2%, 19.0%,15.4%,13.6% and (1.58±0.26) respectively,which were higher than those in normal pregnant women (P<0.05).The content of CD4^+CD25^+Tr (10.82±2.13) and 25(OH)D (17.84±2.23) ng/mL in pregnant women group were lower than those in normal pregnant women group,the difference was statistically significant (P<0.05).Conclusion Increased autoimmune response,CD4^+/CD8^+ ratio,insufficient levels of CD4^+CD25^+Tr and vitamin D may be risk factors for recurrent abortion.