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目的探讨外周血及蜕膜组织中调节性淋巴细胞的比例原因不明复发性流产(URSA)中的作用。方法根据2013年5月至2015年5月在我院就诊的URSA患者的妊娠状态将其分成4组,分别为未孕组67例,早期流产组23例;正常早孕且自愿要求人工终止妊娠的妇女组24例及正常未孕女性组66例为对照组。计划外妊娠要求URSA患者行清宫术后的新鲜蜕膜组织,采用流式细胞仪分析外周血及蜕膜组织中调节性T细胞数量及比例,最终分析4组妇女外周血及蜕膜组织中CD4+、CD25+等调节性T细胞对URSA患者的影响。结果正常早孕妇女外周血CD4+CD25 high T细胞高于正常未孕妇女及URSA流产组,组间比较差异明显(P﹤0.01);URSA未孕患者的外周血CD4+、CD25high T细胞也显著低于正常未孕女性及URSA流产组患者(P﹤0.01);URSA流产患者蜕膜组织中CD4+、CD25high T细胞数量低于正常早孕组(P﹤0.01)。结论 CD4+CD25+调节性T细胞在维持正常妊娠中扮演重要角色,原因不明复发性流产的发生可能与CD4+、CD25+调节性T细胞的数量降低有关。
Objective To investigate the role of regulatory lymphocytes in unexplained recurrent spontaneous abortion (URSA) in peripheral blood and decidua. Methods According to the pregnancy status of URSA patients who were seen in our hospital from May 2013 to May 2015, they were divided into 4 groups, 67 cases of non-pregnant group and 23 cases of early abortion group. In normal early pregnancy, they were asked to terminate their pregnancy voluntarily 24 women in the women group and 66 women in the normal non-pregnant women group as the control group. Unplanned pregnancy URSA patients required removal of fresh decidua after surgery, the use of flow cytometry analysis of peripheral blood and decidual tissue in the number and proportion of regulatory T cells, the final analysis of 4 groups of women with peripheral blood and decidual tissue CD4 + , CD25 + and other regulatory T cells in patients with URSA. Results The CD4 + CD25high T cells in normal pregnant women were significantly higher than those in normal pregnant women and URSA abortion group (P <0.01). The levels of CD4 + and CD25high T cells in peripheral blood of URSA non-pregnant women were also significantly lower The number of CD4 + and CD25high T cells in decidua of URSA abortion patients was lower than that in normal pregnancy group (P <0.01). Conclusions CD4 + CD25 + regulatory T cells play an important role in maintaining normal pregnancy. The unexplained recurrent spontaneous abortion may be related to the decrease of CD4 +, CD25 + regulatory T cells.