染色体核型异常、Th17/Treg免疫失衡与复发性流产的关系及其影响因素分析

Relationship between Chromosome Karyotype Abnormality,Th17/Treg Immune Imbalance and Recurrent Spontaneous Abortion and Analysis of its Influencing Factors

目的:研究染色体核型异常、辅助性T细胞17(Th17)/调节性T细胞(Treg)免疫失衡与复发性流产(RSA)的关系及其影响因素。方法:选择石家庄市妇幼保健院从2019年2月~2022年2月收治的421例RSA患者,记作研究组。另取同期无生殖系统异常女性400例作为对照组。比较两组染色体核型异常、Th17/Treg免疫情况以及各项基线资料。采用多因素Logistic回归分析明确RSA的影响因素。结果:研究组染色体核型异常发生率为10.21%,高于对照组的1.50%(P<0.05)。研究组Th17、Th17/Treg比值高于对照组,而Treg低于对照组(均P<0.05)。研究组文化程度初中及以下、生殖道感染、难闻性气味以及噪音人数占比均高于对照组(均P<0.05)。经多因素Logistic回归分析可得:RSA的危险因素有文化程度初中及以下、生殖道感染、难闻性气味、噪音、染色体核型异常、Th17/Treg比值升高(均P<0.05)。结论:染色体核型异常以及Th17/Treg免疫失衡均会增加RSA的发生风险,且文化程度初中及以下、生殖道感染、难闻性气味、噪音亦会增加RSA的发生风险,临床工作中可根据上述因素制定针对性干预措施,以达到降低RSA发生率的目的。

Objective:To study the relationship between chromosome karyotype abnormality,helper T cell 17(Th17)/regulatory T cell(Treg)immune imbalance and recurrent spontaneous abortion(RSA)and its influencing factors.Methods:421 patients with RSA who were admitted to Shijiazhuang Maternal and Child Health Hospital from February 2019 to February 2022 were enrolled as study group.Another 400 women without abnormal reproductive system in the same period were taken as the control group.The chromosome karyotype abnormality,Th17/Treg immunity and baseline data were compared in the two groups.Multivariate Logistic regression analysis was used to determine the influencing factors of RSA.Results:The incidence of chromosome karyotype abnormality in the study group was 10.21%,which was higher than 1.50%in the control group(P<0.05).The Th17 and Th17/Treg ratio in the study group was higher than that in the control group,but Treg was lower than that in the control group(all P<0.05).The proportion of people with education level junior high school or below,reproductive tract infection,unpleasant odor and noise in the study group were higher than those in the control group(all P<0.05).Multivariate Logistic regression analysis showed that the risk factors of RSA included education level junior high school or below,reproductive tract infection,unpleasant odor,noise,chromosome karyotype abnormality,and increased Th17/Treg ratio(all P<0.05).Conclusion:Chromosomal karyotype abnormalities and Th17/Treg immune imbalance all increase the risk of RSA,and the education level junior high school or below,reproductive tract infection,unpleasant odor,noise will also increase the risk of RSA.In clinical work,targeted intervention measures can be formulated according to the above factors,so as to reduce the incidence of RSA.