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目的探讨转录因子 GATA-3、T-bet 在原因不明复发性流产发病中的作用。方法采用原位杂交方法,检测20例原因不明复发性流产患者(流产组)和20例正常妊娠妇女(正常妊娠组)蜕膜组织中1型辅助性 T 细胞(Th1)特异性转录因子 T-bet 和2型辅助性 T 细胞(Th2)特异性转录因子 GATA-3的 mRNA 表达水平。结果 (1)GATA-3:蜕膜组织中每高倍视野平均 GATA-3阳性细胞数流产组为(25±16)个,正常妊娠组为(38±16)个,两组比较,差异有统计学意义(P<0.05)。(2)T-bet:蜕膜组织中每高倍视野平均 T-bet 阳性细胞数流产组为(59±17)个,正常妊娠组为(46±18)个,两组比较,差异也有统计学意义(P<0.05)。(3)两组妇女蜕膜组织中 GATA-3 mRNA 与 T-betmRNA 的表达水平呈负相关关系(r=-0.55,P<0.01)。结论原因不明复发性流产患者蜕膜组织中 T-bet 表达占优势,GATA-3的表达受抑制,可能诱导了母胎界面 Th1/Th2平衡向 Th1偏移,从而使胚胎遭受免疫攻击而发生流产。
Objective To investigate the role of transcription factors GATA-3 and T-bet in the pathogenesis of unexplained recurrent spontaneous abortion. Methods In situ hybridization was used to detect the expression of Th1-specific transcription factor T-1 in 20 patients with unexplained recurrent spontaneous abortion (abortion group) and 20 normal pregnant women (normal pregnancy group) bet and type 2 helper T cell (Th2) specific transcription factor GATA-3 mRNA expression levels. Results (1) GATA-3: The average number of GATA-3 positive cells per high power field in decidua was (25 ± 16) in abortion group and (38 ± 16) in normal pregnancy group, the difference was statistically significant Significance (P <0.05). (2) T-bet: The average number of T-bet positive cells per high power field in decidua was (59 ± 17) in abortion group and (46 ± 18) in normal pregnancy group, the difference was also statistically significant Significance (P <0.05). (3) There was a negative correlation between GATA-3 mRNA expression and T-bet mRNA expression in decidua of both groups (r = -0.55, P <0.01). Conclusions The expression of T-bet in decidual tissue with unexplained recurrent spontaneous abortion predominates and the expression of GATA-3 is inhibited, which may induce the shift of Th1 / Th2 balance from Th1 / Th2 to Th1 in maternal-fetal interface, resulting in immune abortion.