不明原因复发性自然流产患者炎症及免疫平衡变化的临床意义

摘要/Abstract

摘要： 目的：探讨不明原因复发性自然流产（URSA）患者炎症及免疫平衡变化的临床意义。方法：回顾性分析2019年8月至2022年9月我院收治的86例URSA患者（URSA组）、同期产检的59例健康孕妇（早孕组）及56例健康体检未孕妇女（未孕组）一般临床资料，分析不同组别间炎症及免疫平衡指标差异，探讨炎症及免疫平衡指标在URSA患者中的表达情况。结果：URSA组患者流产史次数高于早孕组、未孕组（P<0.05），但早孕组、未孕组流产史次数比较差异无统计学意义（P＞0.05）。URSA组患者白细胞介素（IL）-6、IL-17、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）水平均高于早孕组、未孕组，IL-10水平低于早孕组、未孕组（P<0.05），但早孕组、未孕组IL-6、IL-17、TNF-α、hs-CRP、IL-10水平比较，差异均无统计学意义（P＞0.05）。URSA组患者T辅助细胞（Th17）、免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）水平均高于早孕组、未孕组，调节性T细胞（Treg）水平低于早孕组、未孕组（P<0.05），但早孕组、未孕组Th17、IgA、IgG、IgM、Treg水平比较，差异均无统计学意义（P＞0.05）。URSA组患者IL-6、IL-17、TNF-α、hs-CRP水平与Th17、IgA、IgG、IgM水平呈正相关，与Treg指标呈负相关（P<0.05）；URSA组患者IL-10水平与Th17、IgA、IgG、IgM水平呈负相关，与Treg指标呈正相关（P<0.05）。结论：炎症因子的异常表达及免疫失衡可能参与URSA的发生。

关键词: 不明原因复发性自然流产, 炎症, 免疫平衡, 炎症因子

Abstract: Objective： To investigate the clinical significance of inflammation and immune balance changes in patients with unexplained recurrent spontaneous abortion (URSA). Methods： The general clinical data of 86 patients with URSA (URSA group)， 59 healthy pregnant women (early pregnancy group) and 56 healthy non-pregnancy women (non-pregnant group) admitted in our hospital from August 2019 to September 2022 were retrospectively analyzed. The differences of inflammation and immune balance indexes among different groups were analyzed， to investigate the expression of inflammation and immune balance indexes in patients with URSA. Results： The abortion times of patients in URSA group was higher than that in early pregnancy group and non-pregnancy group (P<0.05)，but there was no statistical difference between early pregnancy group and non-pregnancy group (P＞0.05). The levels of interleukin-6 (IL)-6， IL-17， tumor necrosis factor (TNF-α) and hypersensitive C-reactive protein (hs-CRP) of patients in URSA group were higher than those in early pregnancy group and non-pregnancy group， and the level of IL-10 of patients in URSA group was lower than that of early pregnancy group and non-pregnancy group (P<0.05). However， there were no statistical differences in the levels of IL-6， IL-17， TNF-α， hs-CRP and IL-10 between early pregnancy group and non-pregnancy group (P＞0.05). The levels of T helper cells (Th17)， immunoglobulin A (IgA)， immunoglobulin G (IgG) and immunoglobulin M (IgM) of patients in URSA group were higher than those in early pregnancy group and non-pregnancy group， and the level of regulatory T cells (Treg) of patients in URSA group was lower than that of early pregnancy group and non-pregnancy group (P<0.05). There were no statistical differences in Th17， IgA， IgG， IgM and Treg levels between early pregnancy group and non-pregnancy group (P＞0.05). The levels of IL-6， IL-17， TNF-α and hs-CRP of patients in URSA group was positively correlated with the level of Th17， IgA， IgG and IgM， and negatively correlated with Treg indices (P<0.05). The level of IL-10 in URSA group was negatively correlated with the level of Th17， IgA， IgG and IgM， and positively correlated with Treg index (P<0.05). Conclusion： The abnormal expression of inflammatory factors and immune imbalance may be involved in the occurrence of URSA.

Key words: Unexplained recurrent spontaneous abortion, Inflammation, Immune balance, Inflammation factors

中图分类号:

R714.21

张玉侠, 蔡武全. 不明原因复发性自然流产患者炎症及免疫平衡变化的临床意义[J]. 中国医药导刊, 2023, 25(12): 1270-1274.

ZHANG Yuxia, CAI Wuquan. Clinical Significance of Inflammation and Immune Balance Changes in Patients with Unexplained Recurrent Spontaneous Abortion#br#[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(12): 1270-1274.

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