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目的:探讨妊娠高血压综合征(妊高征)患者蜕膜组织微环境免疫功能的变化。方法:检测55例不同程度妊高征患者及正常孕妇胎盘蜕膜组织中淋巴细胞的增殖、T细胞及单核细胞分泌的细胞因子,以及他们血清免疫球蛋白及补体的水平。结果:妊高征患者蜕膜组织中,淋巴细胞增殖反应程度(cpm值为1802±89),明显高于正常孕妇组(cpm值为430±56,P<0.01)。T细胞分泌的IL2和IFNγ的水平明显升高(P<0.05),IL4的水平有所下降但没有统计学意义(P>0.05)。与正常孕妇相比,妊高征患者蜕膜组织中单核细胞产生的TNFα和IL1的量明显增多(P<0.01);但患者血清免疫球蛋白及补体的水平却显著降低(P<0.01)。结论:妊高征患者蜕膜组织的免疫微环境发生明显变化:Th1型细胞因子的水平异常升高,T细胞处于免疫激活状态,体液免疫功能降低,可能与妊高征的免疫学发病机制有关。
Objective: To investigate the changes of immune function of decidual tissue microenvironment in patients with pregnancy induced hypertension (PIH). Methods: The levels of lymphocyte proliferation, cytokines secreted by T cells and monocytes, as well as serum immunoglobulin and complement levels in placental decidua of 55 patients with PIH and normal pregnant women were detected. Results: The degree of lymphocyte proliferative reaction (cpm value 1802 ± 89) in decidua of PIH patients was significantly higher than that of normal pregnant women (cpm 430 ± 56, P <0.01). T cells secrete IL2 and IFNγ levels were significantly increased (P <0.05), IL4 levels decreased but not statistically significant (P> 0.05). Compared with normal pregnant women, the amount of TNFα and IL1 produced by monocytes in patients with PIH increased significantly (P <0.01), but the level of serum immunoglobulin and complement was significantly decreased (P <0.01) . Conclusion: The immune microenvironment of decidua in patients with pregnancy induced hypertension significantly changes: Th1-type cytokines abnormally elevated, T cells in the immune activation state, decreased humoral immune function may be related to the immune pathogenesis of pregnancy-induced hypertension .