重度子痫前期孕妇外周血T淋巴细胞亚群和NK细胞变化及其对母婴结局影响

Changes of T lymphocyte subsets and NK cells in peripheral blood of pregnant women with severe preeclampsia and their effcts on the maternal-infant outcomes

目的:探究重度子痫前期(PE)孕妇外周血T淋巴细胞亚群和自然杀伤(NK)细胞的变化及其对母婴结局的影响。方法:将本院2020年6月-2022年6月收治的91例重度PE孕妇纳入研究,根据发病时间分为早发组(早发型重度PE孕妇42例)与晚发组(晚发型重度PE孕妇49例)。比较两组孕妇外周血T淋巴细胞亚群及NK细胞水平,分析T淋巴细胞亚群及NK细胞与重度PE孕妇发病时间的相关性,比较两组母婴结局。结果:两组孕妇外周血CD3^(+)、CD4^(+)水平比较差异无统计学意义(P>0.05),而早发组CD8^(+)及NK细胞水平均高于晚发组,CD4^(+)/CD8^(+)值低于晚发组(P<0.05);外周血CD8^(+)及NK细胞水平均与PE孕妇发病时间呈负相关(r=-0.397、-0.340,P<0.05),CD4^(+)/CD8^(+)比值与PE孕妇发病时间呈正相关(r=0.481,P<0.05);早发组孕妇自然分娩率低于晚发组,剖宫产率及早产、胎盘早剥、胎儿宫内发育迟缓及胎儿窘迫发生率均高于晚发组(P<0.05)。结论:外周血T淋巴细胞亚群及NK细胞可能参与重度PE疾病进展,高水平的CD8^(+)及NK细胞更易造成早发性重度PE。

Objective:To explore the changes of T lymphocyte subsets and NK cells(NK)in peripheral blood of preg-nant women with severe preeclampsia(PE)and their effects on the maternal-infant outcomes.Methods:91 pregnant women with severe PE were included in this study and were divided into group A(42 women with early-onset severe PE)and group B(49 women with late-onset severe PE)according to the onset time of PE from June 2020 to June 2022.The levels of T lymphocyte subsets and NK cells in peripheral blood,and the maternal-infant outcomes of the women were compared between the two groups.The correlation between T lymphocyte subsets and NK cells levels of the women and their onset time of PE with severe PE was analyzed.Results:There were no statistical significant differ-ences in the levels of CD3+and CD4+in peripheral blood of the women between the two groups(P>0.05).The levels of CD8+and NK cells of the women in group A were significantly higher than those of the women in group B,while the CD4^(+)/CD8^(+)level of the women in group A was significantly lower(P<0.05).The levels of CD8+and NK cells in.peripheral blood of the women were negatively correlated with their onset time of PE(r=-0.397,-0.340,P<0.05),.and the CD4^(+)/CD8^(+)ratio of the women was positively correlated with their onset time of PE(r=0.481,P<0.05)..The rate of natural delivery of the women in group A was significantly lower than that of the women in group B,and the rates of cesarean section,premature delivery,placental abruption,intrauterine growth retardation,and fetal dis-tress of the women in group A were significantly higher(P<0.05).Conclusion:T lymphocyte subsets and NK cells in peripheral blood of the women may participate in the progression of their severe PE.High levels of CD8^(+)and NK cells of the women are more likely to cause their early onset severe PE.