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目的探讨重度子痫前期孕妇外周血免疫细胞的病理迁移特征及其对母婴结局的影响。方法选取本院收治的31例重度子痫前期孕妇为观察组,并以同期入院的31例健康孕妇为对照组,进行血清免疫学对照研究;分别抽取2组患者的空腹静脉血,采用流式细胞仪检测辅助性、抑制性、调节性T细胞计数,并采用ELISA试剂盒测定相关细胞因子水平,同时采用全自动生化分析仪测定母体肝功能指标ALT、AST、Cr及肾功能指标BUN、UA、URO的血清含量;结合分娩孕周及新生儿体质量分析重度子痫前期外周血免疫细胞的病理迁移过程。结果观察组的Th1、Th17细胞计数及相应细胞因子分泌水平显著高于对照组(P<0.05),Th2、Ts、Treg细胞计数相应细胞因子分泌水平显著低于对照组(P<0.05);观察组母体肝功能指标ALT、AST、Cr及肾功能指标BUN、UA、URO均显著高于对照组(P<0.05),分娩孕周、新生儿体质量均显著小于或低于对照组(P<0.05)。结论重度子痫前期孕妇外周血存在调节性T细胞相对抑制,抑制性T细胞向辅助性T细胞迁移及辅助性T细胞比例失调三大病理特征,长期的免疫功能亢进可能是母体发生免疫排异和肝肾损伤的重要机制之一。
Objective To investigate the pathological characteristics of immune cells in peripheral blood of pregnant women with severe preeclampsia and its effect on maternal and infant outcome. Methods Totally 31 pregnant women with severe preeclampsia admitted to our hospital were selected as the observation group and 31 healthy pregnant women admitted to the same period as the control group. Serum immunological control study was conducted. Fasting venous blood was drawn from two groups, Cytometry was used to detect secondary, inhibitory, and regulatory T cell counts. ELISA kits were used to measure cytokine levels. ALT, AST and Cr levels were measured by automated biochemical analyzer. BUN, UA , Serum levels of URO; combined with gestational birth and neonatal body mass analysis of severe preeclampsia peripheral blood immune cell migration process. Results The levels of Th1 and Th17 cells and the levels of cytokines secreted by the observation group were significantly higher than those of the control group (P <0.05). The levels of cytokines secreted by Th2, Ts and Treg cells were significantly lower than those of the control group (P <0.05) The levels of ALT, AST, Cr and renal function indexes BUN, UA and URO of maternal liver function group were significantly higher than those of the control group (P <0.05). The weight of gestational week and neonatal birth were significantly lower or lower than that of the control group (P < 0.05). Conclusion There are three pathological features of peripheral blood in severe preeclampsia: regulatory T cells, inhibitory T cell migration to T helper cells, and imbalanced T helper T cells. Long-term immunosuppression may be related to maternal immunologic rejection And liver and kidney damage one of the important mechanisms.