不明原因习惯性流产患者蜕膜自然杀伤细胞活性及表型的研究

Study on the activity and phenotype of decidual natural killer cells in patients with unexplained habitual abortion

目的 :探讨原因不明习惯性流产 (UHA)患者蜕膜自然杀伤 (NK)细胞的数量、表型特征及杀伤活性 ,探讨其在UHA发病中的作用。方法 :选取确定妊娠并难免流产的UHA 32例 ,选取 2 0例正常妊娠行人工流产者作为对照组 ,用流式细胞仪检测两组蜕膜组织中NK细胞数量及表型 ,用改进的乳酸脱氢酶释放法测定NK细胞杀伤活性。结果 :正常早孕蜕膜中CD5 6+CD3- NK细胞占蜕膜单个核细胞的 60 .73± 13.2 4 % ,为蜕膜组织的优势细胞群 ,UHA患者蜕膜中CD5 6+CD3- NK细胞总量与正常妊娠蜕膜组织中相同 ,而其CD5 6+CD16- 亚群却明显低于正常妊娠组 (P <0 .0 5 ) ,CD5 6+CD16+亚群含量及CD5 6+CD16+/CD5 6+CD16- 比值均异常增高 (P均 <0 .0 5 )。UHA组蜕膜组织中NK细胞杀伤活性及其异常增高率均高于正常妊娠组 ,差异均有显著性 (P均 <0 .0 5 )。结论 :NK细胞是孕早期蜕膜组织中的优势细胞群 。

Objective:To determine the activity and phenotype of decidual natural killer (NK) cells in patients with unexplained habitual abortion (UHA).Methods:A total of 32 patients with UHA were studied,and 20 cases of normal pregnant women were selected as control group.The levels of CD56 +CD3 - NK cells and their CD56 +CD16 -,CD56 +CD16 + subsets decidua were detected using two-color flow cytometric analysis.The NK cells activity was measured by improved lactic acid dehydragenase releasing assay. Results:Compared with control group,the proportion of CD56 +CD3 - NK cells in decidual mononuclear cells(DMC) of UHA patients had no difference,but the CD56 +CD16 - NK cell subset decreased and the CD56 +CD16 + subset increased significantly (P<0.05).The decidual NK cells activities of UHA patients were higher than those of normal controls (P<0.05).Conclusions:NK cell is predominant lymphocyte in normal decidua and plays an important role in maintaining successful pregnancy.Abnormally raised activity and disbalanced CD56 +CD16 +,CD56 +CD16 - subsets of decidual NK cell are associated with UHA and may play a role in reproductive failure.