高危型HPV感染不孕症女性患者外周血淋巴细胞亚群水平

Peripheral lymphocyte subsets in high-risk HPV-infected infertility women

目的通过检测高危型人乳头瘤病毒(HPV)感染不孕症女性患者外周血淋巴细胞亚群水平,探讨其免疫功能状态。方法选取妇产科就诊的70例高危型HPV感染[其中24例合并解脲脲原体(UU)感染]的不孕症女性患者为观察组,年龄22~45岁;另选取同期的70例HPV检测阴性的不孕症女性患者为对照组,年龄22~44岁。研究对象于就诊时,采集静脉血采用流式细胞仪检测外周血中淋巴细胞亚群水平,采集宫颈细胞采用FQ-PCR法检测HPV16、18、26、31、33、35、39、45、51、52、53、56、58、59、66、68和82共17高危亚型,采集阴道分泌物采用培养法检测生殖道支原体。结果观察组较对照组外周血NK细胞比例显著降低[(12.39±5.87)%vs(16.79±6.12)%,P<0.05],CD3^+细胞比例显著增高[(73.87±6.36)%vs(69.53±7.17)%,P<0.05],B细胞[(12.64±3.51)%vs(12.80±3.76)%]、CD4^+细胞[(38.51±6.00)%vs(37.37±4.59)%]、CD8^+细胞[(28.21±5.92)%vs(27.47±4.59)%]和CD4^+/CD8^+比值(1.45±0.47 vs 1.39±0.25)差异无统计学意义(P>0.05)。χ^2检验表明,观察组中CD4^+/CD8^+比值≤1.1或≥1.9(参考区间1.0~2.0)的异常比例(41.43%)较对照组(10.00%)有非常显著性升高(P<0.01)。观察组中合并UU感染24例(合并感染率34.29%),与单一HPV感染组(未合并UU感染)外周血NK细胞、B细胞、CD3^+、CD4^+细胞、CD8^+细胞和CD4^+/CD8^+比值相比差异均无统计学意义(P>0.05)。合并UU感染组CD4^+/CD8^+比值异常比例(45.83%)较单一HPV感染组(37.00%)稍高,但差异无统计学意义(P>0.05)。结论高危型HPV感染女性不孕症患者存在免疫功能紊乱,主要表现为CD3^+细胞比例增高,NK细胞比例降低和CD4^+/CD8^+比值异常,该紊乱与不孕之间是否存在因果联系有待进一步研究阐明。在本研究的例数范围内,未发现合并UU感染能协同增强高危型HPV感染女性不孕症患者存在的免疫功能紊乱。

Objective By testing the peripheral lymphocyte subsets in high-risk HPV-infected infertility woman,to investigate their immunological function status.Methods Seventy high-risk HPV-infected infertile women aged 22-45(24 of them combined with UU infection)who were treated in the gynaecology and obstetrics department were enrolled.Seventy high-risk HPV negative infertile patients aged 22-44 were enrolled as control group.The venous blood samples were collected and flow cytometry was applied to test the level of lymphocyte subsets.The cervical cells were collected to test 17 high-risk subsets,including HPV16,18,26,31,33,35,39,45,51,52,53,56,58,59,66,68 and 82,using FQ-PCR.The vaginal secretion were collected to test genital mycoplasmas through cultivation.Results Compared to the control group,in trial group,the proportion of NK cells in peripheral blood was significantly lower[(12.39±5.87)%vs.(16.79±6.12)%,P<0.05];proportion of CD3^+cells was significantly higher[(73.87±6.36)%vs.(69.53±7.17)%,P<0.05];while there was no significant difference in B cells[(12.64±3.51)%vs.(12.80±3.76)%],CD4^+cells[(38.51±6.00)%vs.(37.37±4.59)%],CD8^+cells[(28.21±5.92)%vs.(27.47±4.59)%]or CD4^+/CD8^+ratio(1.45±0.47 vs.1.39±0.25)(P>0.05).In trial group,the abnormal proportion of CD4^+/CD8^+(41.43%)was significantly higher than the negative control group(10.00%,P<0.05).In trial group,there was no significant difference in peripheral NK cells,B cells,CD4^+cells,CD8^+cells or CD4^+/CD8^+ratio between combined infection group and simple infection group(P>0.05).Conclusion High-risk HPV-infected infertile women have immune dysfunction,with rise of CD3^+cell proportion,decline of NK cell proportion,and abnormal CD4^+/CD8^+ratio.Regarding the correlation between such disorder and infertility.In all cases of the trial,it′s not found that the combination with UU infection synergistically enhances the immune dysfunction in high-risk HPV-infected infertility women.