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目的探讨不明原因早期复发性自然流产(RSA)患者和正常对照组早孕子宫蜕膜组织中杀伤细胞免疫球蛋白样受体(KIR)CD158表达的特征。方法选择2009年1月至2010年6月就诊的RSA患者和同期计划生育门诊因计划外孕行人工流产术者各30例,并根据孕周分组,流式细胞术检测蜕膜组织细胞表面标记,比较RSA患者和对照者CD56、CD16、CD158a(KIR2DL1/S1)、CD158b(KIR2DL2/S2)表达的变化规律。结果①RSA患者CD56+细胞数显著少于对照者(P=0.007),CD56+/CD16-细胞较对照组降低(P<0.05);②RSA患者CD158a在CD56+/CD16-细胞表面的表达显著降低(P=0.026);③按孕周分组分析显示,孕7～10周患者CD56+/CD16-细胞表面表达CD158a较同期对照者显著降低(P=0.010);④正常早孕蜕膜组织CD158a、CD158b与CD56表达呈显著正相关(P<0.01)。结论早孕蜕膜组织CD56+/CD16-细胞减少可能为不明原因自然流产的发病机制之一。CD56+/CD16-细胞表面CD158a表达下降与不明原因自然流产有关,且其变化与早孕孕周相关。
Objective To investigate the expression of killer cell immunoglobulin-like receptor (KIR) CD158 in early pregnant women with recurrent spontaneous abortion (UA) and normal controls. Methods From January 2009 to June 2010, 30 cases of RSA patients and the same period of family planning outpatients due to unplanned pregnancy were selected. According to gestational age group, flow cytometry was used to detect the surface markers of decidual cells The changes of CD56, CD16, CD158a (KIR2DL1 / S1) and CD158b (KIR2DL2 / S2) expression in RSA patients and controls were compared. Results ① The number of CD56 + cells in RSA patients was significantly lower than that in controls (P = 0.007), while the level of CD56 + / CD16- cells in RSA patients was lower than that in control group (P <0.05). ② The expression of CD158a on CD56 + / CD16- (P = 0.010) .④The expression of CD158a, CD158b and CD56 in the decidua in normal early pregnancy was significantly higher than that in the control group (P = 0.010); ③The expression of CD158a on CD56 + / CD16- Positive correlation (P <0.01). Conclusions The declination of CD56 + / CD16- cells in early decidual tissue may be one of the pathogenesis of unexplained spontaneous abortion. The decreased expression of CD158a on CD56 + / CD16- cells is associated with unexplained spontaneous abortion and its changes are related to the gestational age of early pregnancy.