卵巢早衰患者淋巴细胞亚群、MIF水平对激素替代治疗预后的影响

Effects of lymphocyte subsets and MIF levels on the prognosis of hormone replacement therapy in patients with premature ovarian failure

目的观察卵巢早衰(premature ovarian failure,POF)患者淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、CD19^(+))、巨噬细胞移动抑制因子(macrophage migration inhibition factor,MIF)水平对激素替代治疗(hormone replacement therapy,HRT)预后的影响.方法前瞻性选取新疆医科大学第五附属医院2018年1月至2020年1月确诊并接受治疗的116例POF患者作为研究对象,均于治疗前收集患者基线资料,检测淋巴细胞亚群、MIF水平,并行HRT,评估患者预后,将患者划分为预后不良组和预后良好组,比较两组基线资料、淋巴细胞亚群、MIF水平,采用回归分析检验淋巴细胞亚群、MIF水平对HRT预后的影响及对HRT预后的预测效能.结果116例POF患者中,有26例预后不良,90例预后良好;初步比较预后不良组和预后良好组基线资料后,经回归分析检验结果显示,CD8^(+)、MIF表达上调是HRT预后不良的危险因素(OR>1,P<0.05);CD4^(+)/CD8^(+)表达上调是HRT预后不良的保护因素(OR<1,P<0.05);绘制受试者工作曲线发现,CD8^(+)、CD4^(+)/CD8^(+)、MIF水平用于预测HRT预后不良的AUC均>0.80,均有一定预测价值.结论POF患者行HRT有一定预后不良风险,CD8^(+)、CD4^(+)/CD8^(+)、MIF水平与HRT预后不良密切相关,并可作为预测指标.

Objective To observe the effect of lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),CD19^(+))and macrophage migration inhibitory factor(MIF)levels on the prognosis of hormone replacement therapy(HRT)in patients with premature ovarian failure(POF).Methods A total of 116 patients with POF who were diagnosed and treated in the Fifth Affiliated Hospital of Xinjiang Medical University from January 2018 to January 2020 were prospectively selected as the research subjects.Baseline data of patients were collected before treatment,lymphocyte subsets and MIF levels were detected,HRT was conducted,and prognosis of patients was assessed,divide the patients into poor prognosis group and good prognosis group,compared the baseline data,lymphocyte subsets,and MIF levels between the two groups,and used regression analysis to test the effect of lymphocyte subsets and MIF levels on the prognosis of HRT and their predictive power for HRT prognosis.Results Among the 116 POF patients,26 had poor prognosis and 90 had good prognosis;after preliminary comparison of the baseline data of the poor prognosis group and the good prognosis group,the results of regression analysis showed that the up-regulation of CD8^(+)and MIF expression was risk factors for poor prognosis of HRT(OR>1,P<0.05);up-regulation of CD4^(+)/CD8^(+)expression was a protective factor for poor prognosis of HRT(OR<1,P<0.05);plotting receiver operating curve found that CD8^(+),CD4^(+)/CD8^(+),and MIF levels were used to predict the AUCs of poor prognosis of HRT were all>0.80,which had certain predictive value.Conclusion HRT in POF patients has a certain risk of poor prognosis,the levels of CD8^(+),CD4^(+)/CD8^(+),MIF are closely related to the poor prognosis of HRT,and can be used as predictive indicators.