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目的研究妊娠期高血压疾病患者外周血和蜕膜组织中CD4+T辅助细胞(Th1)和(Th2)细胞免疫反应的变化,探讨Th1/Th2比率失衡在妊娠期高血压疾病发生中的作用。方法选取住院分娩的子痫前期(PE)患者25例(子痫前期组,包括轻度10例和重度15例),妊娠期高血压患者10例,同期住院分娩的正常孕妇12例和自愿参与实验的年龄匹配的健康未孕妇女12例作为对照组,治疗前抽取各组实验对象空腹肘静脉抗凝血0.5m l送流式检验Thl,Th2细胞百分比及Thl/Th2比率。三组孕妇均于剖宫产术胎盘娩出后,立即搔刮子宫腔取蜕膜制成单细胞悬液,分离离心收集淋巴细胞送流式检验Thl,Th2细胞百分比及Thl/Th2比率。结果①子痫前期组外周血Thl细胞百分比(16.18±3.93)%高于其它各组(P<0.01),PE患者Th1/Th2细胞比率(16.75±3.84)均高于其余各组(P<0.05)。②子痫前期组蜕膜组织中CD4+T细胞中Thl百分比(37.83±12.04)%显著高于其它各组(P<0.001),妊娠期高血压患者蜕膜组织中Thl细胞百分比(16.30±5.36)%也高于正常妊娠妇女(11.79±4.61)%(P<0.05)。PE患者Thl/Th2比率(26.70±9.40)显著高于其余各组(P<0.001),重度PE组(30.11±10.42)高于轻度PE组(21.59±4.25)(P<0.05);妊娠期高血压患者Th1/Th2比率(13.13±5.62)也高于正常妊娠妇女(7.61±4.63)(P<0.05)。结论子痫前期患者体内存在着免疫失衡现象。Thl/Th2细胞平衡向Thl漂移,Th2受抑制可能是妊娠期高血压疾病(包括子痫前期和妊娠期高血压)发生的重要原因。
Objective To study the changes of CD4 + T helper (Th1) and (Th2) cell immune responses in peripheral blood and decidua of patients with gestational hypertension and to explore the role of imbalance of Th1 / Th2 ratio in the development of hypertensive disorders of pregnancy. Methods 25 cases of preeclampsia (PE) in hospital delivery (10 cases of mild preeclampsia, including 10 mild cases and 15 severe cases), 10 cases of hypertensive disorder complicating pregnancy, 12 cases of normal pregnant women hospitalized during the same period and voluntary participation Twelve healthy matched pregnant and non-pregnant women were selected as the control group. Fasting elbow venous anticoagulants (0.5 ml) in each group were collected before treatment and were tested by flow cytometry for Thl, Th2 percentage and Th1 / Th2 ratio. Three groups of pregnant women were cesarean section after placental delivery, immediately scraping the decidua uterine decoction made single cell suspension, centrifuged to collect lymphocytes sent to flow test Thl, Th2 percentage and Thl / Th2 ratio. Results ① The percentage of Th1 cells in peripheral blood of preeclampsia group (16.18 ± 3.93)% was higher than that of other groups (P <0.01), while the ratio of Th1 / Th2 cell in PE patients was 16.75 ± 3.84 (P <0.05) ). ② The percentage of Th1 in CD4 + T cells in preeclampsia group (37.83 ± 12.04%) was significantly higher than that in other groups (P <0.001). The percentage of Th1 cells in decidual tissue in patients with preeclampsia (16.30 ± 5.36% )% Is also higher than that of normal pregnant women (11.79 ± 4.61)% (P <0.05). The Thl / Th2 ratio in PE patients (26.70 ± 9.40) was significantly higher than that in other groups (P <0.001), that in severe PE patients (30.11 ± 10.42) was significantly higher than that in mild PE patients (21.59 ± 4.25) (P <0.05) The Th1 / Th2 ratio in hypertensive patients (13.13 ± 5.62) was also higher than that in normal pregnant women (7.61 ± 4.63) (P <0.05). Conclusions There is an imbalance of immunity in preeclampsia patients. The Thl / Th2 cell balance shifts to Thl, and inhibition of Th2 may be an important reason for the occurrence of hypertensive disorder complicating pregnancy (including preeclampsia and gestational hypertension).