摘要
目的探讨早发性卵巢功能不全(POI)患者雌激素水平与外周血T淋巴细胞亚群及程序性死亡受体1(PD-1)表达量的相关性.方法选取2019年12月至2021年1月就诊于山西省妇幼保健院门诊的POI患者20例为研究组,选取同期孕前健康体检妇女30例为对照组,所有研究对象的年龄为28~40岁.采用流式细胞术检测20例POI患者和30例健康体检妇女外周血中CD4^(+)、CD8^(+)T淋巴细胞,以及CD4^(+)、CD8^(+)T淋巴细胞表面PD-1的表达;分析PO I患者外周血CD4^(+)、CD8^(+)T淋巴细胞百分比及其PD-1表达量与雌二醇(E_(2))、抗缪勒管激素(AMH)、促甲状腺激素(TSH)水平的相关性.结果研究组CD4^(+)T淋巴细胞百分比低于对照组(t=4.919,P<0.05),而CD8^(+)T淋巴细胞百分比高于对照组(t=-3.865,P<0.05);研究组的CD4^(+)PD-1^(+)和CD8^(+)PD-1^(+)表达量均显著低于对照组(t值分别为4.156、5.400,P<0.05).POI患者血清E_(2)水平与CD4^(+)T淋巴细胞百分比呈正相关(r=0.530,P<0.05);血清E_(2)水平与CD4^(+)PD-1^(+)和CD8^(+)PD-1^(+)表达量均呈正相关(r分别为0.415、0.437,P<0.05).POI患者血清AM H水平与CD4^(+)T淋巴细胞百分比呈正相关(r=0.504,P<0.05),与CD8^(+)T淋巴细胞百分比呈负相关(r=-0.430,P<0.05);血清A M H水平与CD4^(+)PD-1^(+)和CD8^(+)PD-1^(+)表达量均呈正相关(r分别为0.415、0.649,P<0.05).PO I患者血清TSH水平与CD4^(+)T淋巴细胞百分比呈负相关(r=-0.400,P<0.05),与CD8^(+)T淋巴细胞百分比呈正相关(r=0.467,P<0.05);血清TSH水平与CD4^(+)PD-1^(+)和CD8^(+)PD-1^(+)表达量均呈负相关(r分别为-0.340、-0.352,P<0.05).结论PO I患者细胞免疫水平降低与E_(2)水平相关.
Objective To investigate correlations of estrogen levels with peripheral blood lymphocyte subsets and expression amount of programmed-death-1 receptor(PD-1)in patients with primary ovarian insufficiency(POI).Methods 20 patients with POI who were diagnozed in Department of Outpatient of Shanxi Provincial Maternity and Child Health Hospital over a period from December,2019 to January,2021 were selected as research subjects.30 healthy women who received pregestational examination in the same period were selected as the controls.Flow cytometry was used to detect lymphocyte subsets CD4^(+),CD8^(+)T levels and expression amounts of PD-1 on the surface of CD4^(+)and CD8^(+)T lymphocytes in peripheral blood of 20 patients with POI and 30 healthy women.Serum levels of estradiol(E_(2)),anti-mullerian hormone(AMH)and thyroid-stimulating hormone(TSH)of the patients and the healthy women were detected by using chemiluminescence method.The correlations of the percentages of CD4^(+)T and CD8^(+)T lymphocytes of the patients with POI and the expression amounts of PD-1 on the surface of CD4^(+)and CD8^(+)T lymphocytes with serum levels of E_(2),AMH and TSH were analyzed statistically.Results The percentage of CD4^(+)T lymphocytes of the POI patients was lower than that of the healthy women in the control group(t=4.919,P<0.05),while the percentage of CD8^(+)T lymphocytes of the POI patients was higher than that of healthy women(t=-3.865,P<0.05).The relative expression amounts of PD-1 in CD4^(+)and CD8^(+)T lymphocytes were both sinificantly lower than those of the healthy women in the control group(t=4.156 and 5.400 respectively,both P<0.05).The level of E_(2) of the POI patients was positively correlated to the percentage of lymphocyte CD4^(+)(r=0.530,P<0.05),and also it was positively correlated with expression amounts of CD4^(+)PD-1^(+)and CD8^(+)PD-1^(+)(r=0.415 and 0.437 respectively,both P<0.05).The serum level of anti-mullerian hormone(AMH)was positively correlated to the percentage of lymphocyte CD4^(+)(r=0.504,P<0.05),while it was negatively correlated with the percentage of lymphocyte CD8^(+)(r=-0.430,P<0.05).The serum level of AMH was positively correlated with the expression amounts of CD4^(+)PD-1^(+)and CD8^(+)PD-1^(+)(r=0.415 and 0.649 respectively,both P<0.05).The serum level of TSH was negatively correlated with the percentage of lymphocyte CD4^(+)(r=-0.400,P<0.05),while it was positively correlated with the percentage of lymphocyte CD8^(+)(r=0.467,P<0.05).And the serum level of FSH was negatively correlated with the expression amounts of CD4^(+)PD-1^(+)and CD8^(+)PD-1^(+)(r=-0.340 and-0.352 respectively,both P<0.05).Conclusion The decreased cellular immunity in these patients with POI is correlated to their serum E_(2) level.
作者
王荣慧
白云
王海青
WANG Ronghui;BAI Yun;WANG Haiqing(Shanxi Medical University,Shanxi Taiyuan 030001,China;Shanxi Provincial Maternity and Child Health Hospital/Shanxi Provincial Children's Hospital,Shanxi Taiyuan 030013,China)
出处
《中国妇幼健康研究》
2022年第1期60-65,共6页
Chinese Journal of Woman and Child Health Research
基金
山西省卫生厅科研课题资助项目(201301040)。
关键词
早发性卵巢功能不全
雌激素水平
免疫功能
程序性死亡受体1
primary ovarian insufficiency(POI)
serum level of estrogen
immunologic function
programmed-death-1receptor(PD-1)
作者简介
王荣慧(1993-),女,住院医师,硕士,主要从事妇科内分泌的研究。;通讯作者:白云,主任医师/教授。
