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目的通过检测正常妊娠者、孕龄期非妊娠者及复发性流产患者(RSA)的细胞因子水平,探究复发性流产患者的发病机制及妊娠结局,为免疫治疗提供理论依据。方法随机选取2014年1月到2015年12月期间,正常妊娠者50名,孕龄期非妊娠者50例,复发性流产患者50例。酶联免疫吸附法(ELISA)测定3组受检者静脉血中的TH1型,TH2型细胞因子水平,对3组细胞因子水平的差异进行相关的分析比较。结果妊娠组与非妊娠组相比,在THl、TH2型细胞因子中,其差异无统计学意义(P>0.05),在TH1,TH2型细胞因子中,流产组与妊娠组及非妊娠组相比,差异具有统计学意义(P<0.01)。RSA患者组、妊娠组及非妊娠组CD4~+、CD8~+、CD16~+CD56~+T淋巴细胞在流产1月后变化水平为逐渐下降至平缓状态,其中1月最高。RSA患者妊娠后CD4~+、CD8~+的比例及CD16~+CD56~+T淋巴细胞的比例均显著低于正常妊娠前,非妊娠组干扰素-γ与白介素-4间存在正相关关系(r=0.368,P=0.02)。结论 TH1型细胞因子表达水平高或TH2型细胞因子表达水平低,将会增加流产机率,RSA患者血液中CD16~+CD56~+T细胞亚群比例比妊娠组及非妊娠组高,导致流产。
Objective To investigate the pathogenesis and pregnancy outcome of patients with recurrent spontaneous abortion by detecting the levels of cytokines in normal pregnant women, gestational age non-pregnant women and recurrent spontaneous abortion patients (RSA), so as to provide a theoretical basis for immunotherapy. Methods From January 2014 to December 2015, 50 normal pregnant women, 50 pregnant women without gestational age and 50 pregnant women with recurrent spontaneous abortion were randomly selected from January 2014 to December 2015. The levels of TH1 and TH2 cytokines in the venous blood of three groups of subjects were determined by enzyme linked immunosorbent assay (ELISA), and the differences of cytokines in the three groups were analyzed and compared. Results Compared with non-pregnant group, there was no significant difference in TH1 and TH2 type cytokines in pregnancy group and non-pregnancy group (P> 0.05). Among TH1 and TH2 type cytokines, abortion group, pregnancy group and non-pregnancy group The difference was statistically significant (P <0.01). The levels of CD4 ~ +, CD8 ~ +, CD16 ~ + CD56 ~ + T lymphocytes in RSA group, pregnancy group and non-pregnancy group gradually decreased to flat state after abortion in January, of which the highest was in January. The proportion of CD4 ~ + and CD8 ~ + and the ratio of CD16 ~ + CD56 ~ + T lymphocytes in RSA patients after pregnancy were significantly lower than those before normal pregnancy, and there was a positive correlation between interferon-γ and interleukin-4 in non-pregnant women r = 0.368, P = 0.02). Conclusion The high expression of TH1-type cytokines or the low expression of TH2-type cytokines will increase the chances of miscarriage. The proportion of CD16 + CD56 + T cells in RSA patients is higher than that in pregnancy and non-pregnancy groups, leading to miscarriage.