梅毒血清固定孕妇不同孕期外周血T细胞亚群及NK细胞水平分析

Detection and analysis of peripheral blood T cell subsets and NK cells in pregnant women with syphilitic seroresistance

目的探究梅毒血清固定孕妇不同孕期外周血T细胞亚群及自然杀伤细胞(NK细胞)水平,为患者的临床治疗提供参考。方法选取深圳市龙岗中心医院妇产科2013年5月至2019年5月间收治的38例梅毒血清固定孕妇作为观察组,选取同期正常备孕健康女性38例作为对照组,比较两组孕妇不同孕期外周血T细胞亚群、NK细胞水平及妊娠结局。结果观察组孕妇妊娠前、妊娠早期、妊娠中期以及妊娠晚期的CD3+、CD8+和NK细胞水平比较差异均无统计学意义(P>0.05);而观察组孕妇妊娠前、妊娠早期、妊娠中期以及妊娠晚期的CD4+水平分别为(35.2±5.3)%、(32.1±4.6)%、(28.1±4.3)%、(29.7±4.7)%,明显低于对照组的(40.1±6.1)%、(36.1±5.4)%、(31.9±5.8)%、(33.3±5.4)%,差异均有统计学意义(P<0.05);观察组孕妇妊娠过程中CD3+、CD8+以及NK细胞水平先降低后升高,而CD4+水平先升高后降低,组内比较差异均有统计学意义(P<0.05);观察组孕妇的新生儿先天梅毒5例,TRUST试验显示新生儿11个月全部转阴。结论梅毒血清固定孕妇不同孕期外周血T细胞亚群及NK细胞的变化存在差异,妊娠时胎儿相对安全,先天性梅毒患儿风险较小。

Objective To investigate the levels of T cell subsets and natural killer cells(NK cells) in peripheral blood of pregnant women with syphilitic sero-resistance at different pregnancy stages. Methods Thirty-eight pregnant women with syphilitic sero-resistance were selected as the observation group from May 2013 to May 2019 in the Department of Gynecology and Obstetrics, Shenzhen Longgang Central Hospital, and 38 healthy pregnant women were selected as the control group. The peripheral blood T cell subsets, NK cell levels, and pregnancy outcomes of the two groups were compared. Results There was no statistically significant difference in CD3+, CD8+, NK cell levels of pregnant women in the observation group before pregnancy, at pre-pregnancy, middle pregnancy, and late pregnancy. The CD4+levels of pregnant women in the group before pregnancy, at early pregnancy, middle pregnancy, and late pregnancy were(35.2±5.3)%,(32.1±4.6)%,(28.1±4.3)%,(29.7±4.7)%, which were significantly lower than(40.1±6.1)%,(36.1±5.4)%,(31.9±5.8)%,(33.3±5.4)% in the control group(P<0.05). During the process, the levels of CD3+, CD8+, and NK cells decreased first and then increased, and there was a statistically significant difference within the group(P<0.05), while the levels of CD4+increased first and then decreased, and there was a statistically significant difference within the group(P<0.05). There were 5 cases of congenital syphilis in the newborns of pregnant women in the observation group. The TRUST test showed that all the newborns turned negative in 11 months. Conclusion Pregnant women with syphilitic sero-resistance have different changes in peripheral blood T cell subsets and NK cells during pregnancy. The fetus is relatively safe during pregnancy, and there is a lower risk of children with congenital syphilis.