妊娠期尖锐湿疣患者外周血Treg/Th17细胞平衡及对妊娠结局的影响

The balance of the proportion of Treg to Th17 cell in peripheral blood of pregnant women with condyloma and its influence on their pregnancy outcomes

目的:探究妊娠期尖锐湿疣(CA)患者外周血Treg/Th17细胞含量及与妊娠结局关系。方法:选取2018年10月-2020年10月本院妇产科诊治的妊娠期CA患者112例为CA组,同期正常妊娠孕妇112例为对照组。流式细胞仪检测孕妇外周血Treg、Th17细胞比例,并分析外周血Treg/Th17细胞失衡对CA孕妇妊娠结局的影响。结果:CA组外周血Treg(4.56±1.44)%、Treg/Th17(4.38±1.48)细胞水平均高于对照组(2.60±0.72)%、(1.64±0.56),Th17(1.04±0.35)%细胞水平低于对照组(1.62±0.46)%(均P<0.05)。ROC曲线分析显示,外周血Treg、Th17及Treg/Th17细胞水平诊断CA(AUC=0.813、0.814、0.946)均有一定价值。Treg/Th17失衡CA患者剖宫产(50.0%)及产钳助产率(12.9%)均高于未失衡者(28.6%、4.8%),自然分娩率(37.1%)低于未失衡者(66.7%)(P<0.05);但CA患者Treg/Th17失衡者与未失衡者间,足月产、早产、流产及围产儿死亡、新生儿窒息、人乳头瘤病毒(HPV)阳性率、出生后低体质量,以及6个后随访新生儿HPV感染、呼吸道乳头状瘤的发生率等均未见差异(均P>0.05)。结论:妊娠期CA患者存在外周血Treg/Th17细胞失衡,一定程度影响了产妇分娩结局,但对母婴不良妊娠结局无明显影响。

Objective: To investigate the proportion of Treg to Th17(Treg/Th17) cells in peripheral blood of pregnant women with condyloma(CA), and to study its influence on the pregnancy outcomes of these women. Methods: From October 2018 to October 2020, 112 pregnant women with CA were selected in study group, and 112 normal pregnant women were selected in control group during the same period. Flow cytometry was used to detect the proportion of Treg/Th17 cells in peripheral blood of the women in the two groups. The influence of the imbalance of Treg/Th17 cells in peripheral blood of the women with CA on their pregnancy outcomes was analyzed. Results: The level of Treg(4.56±1.44%) and the proportion of Treg/Th17 cells(4.38±1.48) in peripheral blood of the women in the study group were significantly higher than those(2.60±0.72% and 1.64±0.56) of the women in the control group. The levels of Th17(1.04±0.35%) in peripheral blood of the women in the study group was significantly lower than that(1.62±0.46%) of the women in the control group(all P<0.05). ROC curve analysis showed that the Treg and Th17 levels, and the proportion of Th17 and Treg/Th17 cells in peripheral blood of the women had certain values for diagnosing CA(AUC=0.813, 0.814, and 0.946). The rates of cesarean delivery(50.0%) and forceps delivery(12.9%) of the women with CA and the imbalance of Treg/Th17 cells were significantly higher than those(28.6% and 4.8%) of the women without the imbalance of Treg/Th17 cells, but the rate of natural delivery(37.1%) of the women with CA and the imbalance of Treg/Th17 cells was significantly lower than that(66.7%)of the women without the imbalance of Treg/Th17 cells(P<0.05).There were no significant differences in the rates of full-term birth,preterm birth,abortion,and HPV positive rate of the women,and the rates of perinatal death,neonatal asphyxia,neonatal low body weight,and the incidences of neonatal HPV infection and respiratory papilloma after followed up for 6 months of born between of the women with the imbalance of Treg/Th17 cells and the women without the imbalance of Treg/Th17 cells(all P>0.05).Conclusion:The women with CA have the imbalance of Treg/Th17 cells in peripheral blood during pregnancy,which may affect the maternal delivery outcomes to a certain extent,but has no significant impact on the adverse pregnancy outcomes of both mothers and infants.