NKT样细胞在不明原因反复自然流产中的价值

The value of NKT-like cells in unexplained recurrent spontaneous abortion

目的探讨自然杀伤T(natural killer T,NKT)样细胞在不明原因反复自然流产(unexplained recurrent spontaneous abortion,URSA)中的价值。方法选取2015年1月至2018年5月陕西省人民医院收治120例女性作为本次研究对象,将其分为三组:URSA组,对照A组(正常妊娠女性)和对照B组(正常未孕女性),每组40例。利用流式细胞技术检测CD3+T淋巴细胞和NKT样细胞亚群(CD3+CD16+CD56+、CD3+CD16+CD56-)的表达,采用酶联免疫分析法(enzyme linked immunosorbant assay,ELISA)检测血清γ-干扰素(interferon-γ,IFN-γ)、白细胞介素(interleukin,IL)-4、三种孕激素,β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-HCG)、孕酮(progesterone,P)、雌二醇(estradiol,E2)的水平。结果URSA组、对照A组和对照B组的CD3+T淋巴细胞和CD3+CD16+CD56-NKT样细胞亚型差异无有统计学意义(P>0.05)。对三组的CD3+CD16+CD56+NKT样细胞亚型表达进行比较,结果显示对照A组和对照B组的CD3+CD16+CD56+NKT样细胞亚型表达明显高于URSA组[A组:(4.02±1.54)%,B组:(1.92±1.02)%,URSA组:(6.45±2.09)%],差异具有统计学意义(F=18.596,P<0.05)。URSA组的IFN-γ表达水平明显高于对照A组[(110.27±50.12)ng/L比(69.38±31.25)ng/L,t=4.380,P<0.05];URSA组的IL-4表达水平明显低于对照A组[(21.34±10.02)ng/L比(40.97±19.85)ng/L,t=5.583,P<0.05];URSA组的Th1/Th2比值明显高于对照A组[(6.84±2.49)比(2.34±1.74),t=9.370,P<0.05]。同时,URSA组的血清β-HCG、P、E2的表达水平均低于对照A组,差异均具有统计学意义(t值分别为45.778、11.992和21.922,P值均<0.05)。结论NKT样细胞的表达在URSA中起着重要的作用,为临床上URSA患者的诊断和治疗提供了依据。

Objective To explore the value of natural killer T(NKT)like cell in unexplained recurrent spontaneous abortion(URSA).Methods Total of 120 women in Shaanxi Provincial People's hospital were selected from January 2015 to May 2018,and divided into three groups:URSA group,control group A(normal pregnant women)and control group B(normal non pregnant women),with 40 cases in each group.The expression of CD3+T lymphocytes and NKT like cell subsets(CD3+CD16+CD56+,CD3+CD16+CD56-)were detected by flow cytometry.The levels of serum interferon-γ(IFN-γ),interleukin(IL)-4,three kinds of progesterone,β-human chorionic gonadotropin(β-HCG),progesterone(P)and estradiol(E2)were measured by enzyme linked immunosorbent assay(ELISA).Results There were no statistical differences in CD3+T lymphocytes and CD3+CD16+CD56-NKT-like cell subsets among URSA group,control group A and control group B(P>0.05).The results showed that the expression of CD3+CD16+CD56+NKT like cell subtypes in control group A and control group B was significantly higher than that in URSA group[group A:(4.02±1.54)%,group B:(1.92±1.02)%,URSA group:(6.45±2.09)%,F=18.596,P<0.05].The level of IFN-γin URSA group was significantly higher than that in control group A[(110.27±50.12)ng/L vs(69.38±31.25)ng/L,t=4.380,P<0.05],the level of IL-4 in URSA group was significantly lower than that in control group A[(21.34±10.02)ng/L vs(40.97±19.85)ng/L,t=5.583,P<0.05],and the Th1/Th2 ratio in URSA group was significantly higher than that in control group A[(6.84±2.49)vs(2.34±1.74),t=9.370,P<0.05].At the same time,the expression levels of serumβ-hCG,P and E2 in URSA group were lower than those in control group A(t values were 45.778,11.992 and 21.922 respectively,all P values<0.05).Conclusion The expression of NKT like cells plays an important role in URSA,which provides a basis for the diagnosis and treatment of URSA patients.