论文部分内容阅读
目的研究复发性自然流产(RSA)患者外周血淋巴细胞Fas/FasL表达水平,探讨Fas/FasL系统与RSA的发病关系以及主动免疫治疗对RSA患者外周血淋巴细胞Fas/FasL表达水平的影响。方法收集2009年6月至2010年4月在汕头大学医学院附属粤北人民医院妇产科门诊就诊的早孕期RSA患者12例,未孕期RSA患者15例作为研究组,采用荧光标记流式细胞分析技术分别检测主动免疫治疗前后外周血淋巴细胞Fas、FasL表达水平,选择同期正常早孕妇女15例,正常未孕妇女15例作为对照组,比较各组Fas、FasL表达水平的差异。结果 (1)未孕组中,RSA患者外周血NK细胞和CD8+T细胞Fas的表达水平均比正常妇女高,NK细胞FasL表达水平比正常妇女低(P<0.05),CD8+T细胞FasL、CD4+T细胞Fas、FasL的表达水平两组相比无明显差异(P>0.05);(2)早孕组中,RSA患者外周血NK细胞Fas、FasL的表达水平均比正常妇女低,CD8+T细胞Fas表达水平比正常妇女高(P<0.05),CD8+T细胞FasL、CD4+T细胞Fas、FasL的表达水平两组相比则无明显差异(P>0.05);(3)主动免疫治疗后RSA患者(早孕组和未孕组)外周血NK细胞和CD8+T细胞的Fas表达水平均较治疗前下降,FasL表达水平均较治疗前上升,差异有统计学意义(P<0.05),CD4+T细胞Fas、FasL的表达水平与治疗前相比无明显差异(P>0.05)。结论 (1)外周血NK细胞和CD8+T细胞Fas表达升高,FasL表达不足是导致RSA发生的重要免疫学因素之一。(2)主动免疫治疗可能通过改变RSA患者外周血NK细胞和CD8+T细胞的Fas/FasL表达水平,改善细胞凋亡状态而取得疗效。
Objective To investigate the expression of Fas / FasL in peripheral blood lymphocytes in patients with recurrent spontaneous abortion (RSA) and to explore the relationship between Fas / FasL system and RSA and the effect of active immunotherapy on the expression of Fas / FasL in peripheral blood lymphocytes in patients with RSA. Methods From June 2009 to April 2010, 12 cases of early-stage RSA patients and 15 cases of non-pregnant RSA patients were interviewed at the Department of Obstetrics and Gynecology of Yuebei People’s Hospital affiliated to Shantou University Medical School. The fluorescent-labeled flow cytometry The expression levels of Fas and FasL in peripheral blood lymphocytes were measured respectively by immunocytochemistry and immunocytochemistry. Fifteen normal early pregnant women and 15 normal pregnant women were selected as the control group, and the differences of the expression of Fas and FasL in each group were compared. Results (1) The expression levels of Fas in peripheral blood NK cells and CD8 + T cells in RSA patients were higher than those in normal women, and the expression levels of FasL in NK cells were lower than those in normal women (P <0.05) (P> 0.05). (2) The expression levels of Fas and FasL in peripheral blood NK cells in RSA patients were lower than those in normal women in the early pregnancy group, while the levels of CD8 (P <0.05). There was no significant difference in the expression levels of Fas, FasL and FasL between CD8 + T cells and CD4 + T cells (P> 0.05) The expression of Fas in NK cells and CD8 + T cells in peripheral blood of RSA patients (early pregnancy group and non-pregnant group) after immunotherapy was lower than that before treatment, and the level of FasL expression was significantly higher than that before treatment (P <0.05 ), The expression levels of Fas and FasL in CD4 + T cells were not significantly different from those before treatment (P> 0.05). Conclusions (1) The expression of Fas in peripheral blood NK cells and CD8 + T cells is increased, and the insufficient expression of FasL is one of the important immunological factors leading to RSA. (2) Active immunotherapy may achieve therapeutic effect by changing the expression of Fas / FasL in peripheral blood NK cells and CD8 + T cells in RSA patients and improving the apoptosis status.