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目的探讨胎儿淋巴细胞在妊娠肝内胆汁淤积症(ICP)发病中的作用。方法采用单向混合淋巴细胞反应法,检测20例ICP患者(ICP组)及20例正常孕妇(对照组)的脐血胎儿淋巴细胞与母体外周血已灭活的淋巴细胞、皮肤组织可溶性抗原、蜕膜组织可溶性抗原的增殖反应情况。结果(1)ICP组脐血胎儿淋巴细胞与母体已灭活的淋巴细胞混合反应中,胎儿淋巴细胞的增殖反应程度为2．75±0．36,显著高于对照组的1．45±0．19,两组比较,差异有统计学意义(P＜0．05)；(2) ICP组脐血胎儿淋巴细胞与母体蜕膜组织可溶性抗原混合反应中,胎儿淋巴细胞的增殖反应程度为1．45±0．19,显著高于对照组的0．67±0．24,两组比较,差异有统计学意义(P＜0．05)；(3)ICP组脐血胎儿淋巴细胞与母体皮肤组织可溶性抗原反应中,胎儿淋巴细胞的增殖反应程度为1．22±0．44,显著高于对照组的0．66±0．27,两组比较,差异有统计学意义(P＜0．05)。结论胎儿淋巴细胞可能是ICP发病过程中的主要效应细胞之一；母-胎间免疫失衡是ICP发病的重要机制之一。
Objective To investigate the role of fetal lymphocytes in the pathogenesis of intrahepatic cholestasis of pregnancy (ICP). Methods Unidirectional mixed lymphocyte reaction was used to detect cord blood fetal lymphocytes in 20 patients with ICP (ICP group) and 20 normal pregnant women (control group), lymphocytes in maternal peripheral blood, soluble antigen in skin tissue, Decidual Tissue Soluble Antigen Proliferation Response. Results (1) In the mixed reaction of umbilical cord blood lymphocytes and maternal inactivated lymphocytes in ICP group, the degree of fetal lymphocyte proliferation was 2.75 ± 0.36, which was significantly higher than that of the control group (1.45 ± 0) (P <0.05). (2) In the mixed reaction of fetal umbilical cord blood cells and maternal decidua with soluble antigen in ICP group, the degree of fetal lymphocyte proliferation reaction was 1 .45 ± 0.19, which was significantly higher than that of the control group (0.67 ± 0.24). There was significant difference between the two groups (P <0.05). (3) The cord blood fetal lymphocytes and maternal In the skin tissue soluble antigen, the degree of fetal lymphocyte proliferation was 1.22 ± 0.44, which was significantly higher than that of the control group (0.66 ± 0.27, P <0 .05). Conclusion Fetal lymphocytes may be one of the main effector cells in ICP pathogenesis. The imbalance between mother and fetus is one of the important mechanisms of ICP pathogenesis.