摘要
目的探究原因不明复发性流产(URSA)患者外周血程序性细胞死亡分子1(PD-1)、辅助性T淋巴细胞1/辅助性T淋巴细胞2(Th1/Th2)型细胞因子表达及意义。方法选取2017年11月-2019年11月攀枝花市中西医结合医院收治的63例URSA患者作为研究组,同期选取57名正常早孕妇女和61名正常非孕妇女分别为正常妊娠组、正常非孕组。检测外周血PD-1、Th1/Th2型细胞因子[干扰素γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)]水平,绘制受试者工作曲线(ROC)分析外周血各指标单一及联合预测URSA妊娠结局价值,Pearson分析各指标间相关性。结果研究组外周血IFN-γ、TNF-α水平高于正常妊娠组和正常非孕组,PD-1、IL-10水平低于正常妊娠组和正常非孕组,差异有统计学意义(P<0.05)。治疗后研究组保胎失败者外周血IFN-γ、TNF-α水平高于保胎成功者,PD-1、IL-10水平低于保胎成功者,差异有统计学意义(P<0.05)。URSA患者外周血PD-1与IFN-γ、TNF-α成负相关(r=-0.529、-0.551,P均<0.001),与IL-10成正相关(r=0.507,P<0.001);外周血IFN-γ与TNF-α成正相关(r=0.617,P<0.001),与IL-10成负相关(r=-0.485,P<0.001);外周血TNF-α与IL-10成负相关(r=-0.554,P<0.001)。Th1/Th2型细胞因子与PD-1联合预测URSA妊娠结局的AUC为0.957(95%CI:0.873~0.992),优于各指标单一预测以及Th1/Th2型细胞因子联合预测。结论外周血PD-1可能通过调节Th1/Th2型细胞因子表达参与URSA形成,可作为本病潜在治疗靶点。
Objective To investigate the level of programmed cell death molecule 1(PD-1),helper T lymphocyte 1/helper T lymphocyte 2(Th1/Th2)cytokines in peripheral blood of patients with unexplained recurrent spontaneous abortion(URSA)and their correlation.Methods From November 2017 to November 2019,63 URSA patients in the Panzhihua integrated traditional Chinese and Western medicine hospital were selected as the study group,and 57 normal early pregnancy women and 61 normal non-pregnant women were selected as the normal pregnancy group and the normal nonpregnant group during the same period.The levels of peripheral blood PD-1,Th1/Th2 type cytokines[interferonγ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-10(IL-10)]levels were measured,and ROC was used to analyze the value of single and combined prediction of URSA pregnancy outcome with peripheral blood indicators,and Pearson was used to analyze the correlation between the indicators.Results Peripheral blood IFN-γand TNF-αlevels in the study group were higher than those in normal pregnancy group and normal non-pregnancy group,while PD-1 and IL-10 levels were lower than those in normal pregnancy group and normal non-pregnancy group(P<0.05).After treatment,the levels of IFN-γand TNF-αin the peripheral blood of the study group failure patients were higher than those of the successful pregnancy protection,and the levels of PD-1 and IL-10 were lower than those of the successful pregnancy protection(P<0.05).PD-1 in peripheral blood of URSA patients was negatively correlated with IFN-γand TNF-α(r=-0.529,-0.551,all P<0.001),and positively correlated with IL-10(r=0.507,P<0.001),IFN-γin peripheral blood was positively correlated with TNF-α(r=0.617,P<0.001),negatively correlated with IL-10(r=-0.485,P<0.001),and TNF-αin peripheral blood was negatively correlated with IL-10(r=-0.554,P<0.001).The AUC of Th1/Th2 cytokines combined with PD-1 to predict the outcome value of URSA pregnancy was 0.957(95%CI:0.873-0.992),which was better than any single prediction index.Conclusion PD-1in peripheral blood might participate in the formation of URSA by regulating the expression of Th1/Th2 type cytokines,and could be used as a potential therapeutic target for this disease.
作者
程瑶瑶
张雨婷
母岺
宋化雨
陈娟
弋杰
杨键
CHENG Yao-yao;ZHANG Yu-ting;MU Ling;SONG Hua-yu;CHEN Juan;YI Jie;YANG Jian(Department of Obstetrics and Gynecology,Panzhihua Integrated Traditional Chinese and Western Medicine Hospital,Panzhihua,Sichuan 617000,China)
出处
《热带医学杂志》
CAS
2022年第10期1361-1366,共6页
Journal of Tropical Medicine
基金
四川省科技计划项目(2018JDR2386)
作者简介
程瑶瑶,女,本科,主治医师,研究方向:妇产科;通信作者:陈娟,E-mail:93054793@qq.com
