复发性流产患者主动免疫治疗前后种植窗外周血及子宫内膜淋巴细胞亚群变化-东南大学学报医学版

复发性流产患者主动免疫治疗前后种植窗外周血及子宫内膜淋巴细胞亚群变化

单位：南方医科大学附属深圳市妇幼保健院妇科, 广东深圳 518000

关键词：复发性流产种植窗主动免疫治疗子宫内膜淋巴细胞子宫内膜自然杀伤细胞流式细胞术

分类号：R714.21

出版年·卷·期（页码）：2018·37·第一期（91-96）

摘要：

目的：探讨不明原因复发性流产患者（URSA）种植窗口期子宫内膜淋巴细胞亚群在淋巴细胞主动免疫治疗（LIT）后比例的变化。方法：采用流式细胞术检测并比较20名URSA患者LIT前后种植窗口期外周血中及子宫内膜中CD3^-CD（56+16）⁺自然杀伤细胞（uterine natural killer cell uNK）、CD3⁺CD4⁺CD8^-、CD3⁺CD4^-CD8⁺T淋巴细胞亚群比例变化。结果：1.与治疗前相比，治疗后URSA患者种植窗口期子宫内膜CD3⁺CD4⁺CD8^-T细胞亚群的比例显著下降（t=3.59，P < 0.01）；CD3^-CD（56+16）⁺ uNK细胞亚群比例在治疗后显著升高（t=-4.87，P < 0.01）；CD3⁺CD4^-CD8⁺T细胞亚群的比例LIT后的比例无显著性差异。2.免疫治疗前后外周血各淋巴细胞亚群比例无显著性变化。结论：1.种植窗口期子宫内膜淋巴细胞亚群比例失衡可能是复发性流产的病因之一。2.淋巴细胞主动免疫治疗后，子宫内膜局部淋巴细胞亚群比例的变化，有利于再次妊娠。3.外周血淋巴细胞亚群与子宫内膜相应淋巴细胞亚群间比例无显著相关性，外周血淋巴细胞亚群比例不能用于评估子宫内膜局部的免疫状态。

Objective: To investigate the alternation of endometrial and peripheral lymphocyte subpopulation while "implantation window" in unexplained recurrent spontaneous abortion(URSA) patients after lymphocyte immunization therapy(LIT). Methods: The endometrial and peripheral uterine nature killer cell, CD3⁺CD4⁺CD8^-T cell and CD3⁺CD4^-CD8⁺T cell while "implantation window" in 20 URSA patients were detected by flow cytometry and compared before and after lymphocyte immunization therapy. Results: 1.The percentage of CD3⁺CD4⁺CD8^-T cell had significantly decreased after LIT whereas the percentage of CD3^-CD(56+16)⁺ uNK cell had significantly increased,CD3⁺CD4^-CD8⁺T cell had not significantly changed after LIT. 2. The percentage of peripheral T lymphocyte subpopulation and NK cell had not significantly after LIT.3. There was no significant correlation between peripheral and endometrial lymphocyte subpopulation. Conclusion: 1.The disorder of the endometrial T lymphocyte subpopulation and uNK cell could be one of the causes of URSA. 2. The alternation of the percentage of endometrial lymphocyte subpopulation could be beneficial for next conception after LIT. 3. There had been no correlation between the percentages of peripheral lymphocyte and uterine lymphocyte subpopulation, the percentages of peripheral lymphocyte could not be used to evaluate the immune status in local uterine endometrium.

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