卵巢囊肿患者外周血T淋巴细胞亚群与卵巢储备功能下降发生风险的相关性研究

Correlation between peripheral blood T lymphocyte subsets and the risk of decreased ovarian reserve function in patients with ovarian cyst

目的分析卵巢囊肿患者外周血中T淋巴细胞亚群和卵巢储备功能降低发生风险的相关性。方法选取2019年5月至2021年5月济南市第五人民医院收治的卵巢囊肿患者98例进行研究,均开展性激素及卵巢储备功能有关指标检测,依据检测结果分为卵巢储备功能降低组(40例)和正常组(58例)。流式细胞仪测定各组人群外周血中T淋巴细胞亚群水平,Logistic回归分析两组患者外周血中T淋巴细胞亚群水平差异,确定其与卵巢储备功能降低发生风险的相关性。结果经检测98例卵巢囊肿患者中40例出现卵巢储备功能降低纳入卵巢储备功能降低组;余下58例未出现卵巢储备功能降低纳入正常组。卵巢储备功能降低组患者黄体生成素(luteinizing hormone,LH)、卵泡生成素(follicular-stimulating hormone,FSH)水平高出正常组,孕酮(progesterone,P)、睾酮(testosterone,T)、雌二醇(estradiol,E2)、泌乳素(prolactin,PRL)、抑制素A(inhibin A,INHA)、抑制素B(inhibin B,INHB)以及抗苗勒管激素(anti-mullerian hormone,AMH)水平均低于正常组(P值均<0.05)。降低组患者CD3^(+)、CD8^(+)水平高于正常组[(73.58±5.46)%比(67.20±8.36)%,(35.62±4.28)%比(25.36±4.50)%,t值分别为4.24和11.32,P值均<0.05],CD4^(+)、CD4^(+)/CD8^(+)水平低于正常组[(32.85±3.84)%比(38.74±5.15)%、(0.95±0.16)比(25.36±4.50),t值分别为60.15和14.76,P值均<0.05]。Logistic回归方程表明CD3^(+)水平升高、CD4^(+)水平降低、CD8^(+)水平升高以及CD4^(+)/CD8^(+)水平降低均是卵巢肿瘤患者发生卵巢储备功能降低的影响因素(OR值均>1)。结论卵巢囊肿患者外周血T淋巴细胞亚群和卵巢储备功能降低发生风险之间存在相关性,CD3^(+)、CD8^(+)水平升高,CD4^(+)、CD4^(+)/CD8^(+)水平降低者发生卵巢储备功能降低的风险更高。

Objective To analyze the correlation between T lymphocyte subsets in peripheral blood and the risk of reduced ovarian reserve function in patients with ovarian cyst.Methods A total of 98 patients with ovarian cysts treated in Jinan Fifth People's Hospital from May 2019 to May 2021 were selected for the study.The relevant indexes of sex hormone and ovarian reserve function were tested.According to the test results,40 cases were divided into the decreased ovarian reserve function group and 58 cases were divided into the normal group.Flow cytometry was used to measure the level of T lymphocyte subsets in peripheral blood of each group.Logistic regression was used to analyze the difference of T lymphocyte subsets in peripheral blood between the two groups to determine the correlation between T lymphocyte subsets and the risk of decreased ovarian reserve function.Results Among 98 patients with ovarian cyst,40 patients with decreased ovarian reserve function were included in the reduced ovarian reserve function group;The remaining 58 cases without decreased ovarian reserve function were included in the normal group.The levels of luteinizing hormone(LH)and follicular stimulating hormone(FSH)in patients with decreased ovarian reserve function were higher than those in the normal group.Progesterone(P),testosterone(T),estradiol(E2),prolactin(PRL),inhibin A(InhA),inhibin B(inhb)and anti-mullerian hormone(AMH)were lower than those in the normal group(all P values<0.05).The levels of CD3^(+)and CD8^(+)in the decreased group were higher than those in the normal group[(73.58±5.46)%vs(67.20±8.36)%,(35.62±4.28)%vs(25.36±4.50)%,t values were 4.24 and 11.32,both P values<0.05],and the levels of CD4^(+)and CD4^(+)/CD8^(+)in the decreased group were lower than those in the normal group[(32.85±3.84)%vs(38.74±5.15)%,(0.95±0.16)vs(25.36±4.50),t values were 60.15 and 14.76,both P values<0.05].Logistic regression showed that the increase of CD3^(+)level,the decrease of CD4^(+)level,the increase of CD8^(+)level and the decrease of CD4^(+)/CD8^(+)level were the influencing factors for the decrease of ovarian reserve function in patients with ovarian tumors(the OR values>1).Conclusion There is a correlation between T lymphocyte subsets in peripheral blood and the risk of decreased ovarian reserve function in patients with ovarian cyst.The levels of CD3^(+)and CD8^(+)increased,and the risk of decreased ovarian reserve function was higher in patients with decreased levels of CD4^(+)and CD4^(+)/CD8^(+).