CAJ | 학술논문

目的：探讨外周血程序性细胞死亡分子1（PD-1）及血清中Th1/Th2型细胞因子变化在原因不明复发性流产（URSA）发病中的作用。方法采用流式细胞术测定140例URSA患者接受淋巴细胞免疫治疗前后外周血PD-1水平；采用ELISA法测定患者治疗前后血清Th1（IL-2、IFN-γ）/Th2（IL-4、IL-10）型细胞因子水平，同时以102例正常已生育妇女作为对照组。结果（1）淋巴细胞免疫治疗前与对照组相比，PD-1和Th2型细胞因子（IL-4和IL-10）显著下降（P均＜0.05）。（2）淋巴细胞免疫治疗后与治疗前相比，Th1型细胞因子（IL-2和IFN-γ）含量明显下调（P均＜0.05）。（3）淋巴细胞免疫治疗后与对照组相比，PD-1、Th1/Th2型细胞因子水平无显著性差别（P均＞0.05）。（4）URSA患者外周血PD-1含量和血清中Th2型细胞因子水平呈正相关（r＝0.67，r＝0.81，P均＜0.05）；与Th1型细胞因子呈负相关（r＝-0.55，r＝-0.73，P均＜0.05）。（5）淋巴细胞免疫治疗后，妊娠成功的妇女PD-1表达水平显著高于妊娠失败者（P＜0.05）。结论 PD-1可能通过下调Th1/Th2型细胞因子的水平抑制URSA的发生发展。
목적：탐토외주혈정서성세포사망분자1（PD-1）급혈청중Th1/Th2형세포인자변화재원인불명복발성유산（URSA）발병중적작용。방법채용류식세포술측정140례URSA환자접수림파세포면역치료전후외주혈PD-1수평；채용ELISA법측정환자치료전후혈청Th1（IL-2、IFN-γ）/Th2（IL-4、IL-10）형세포인자수평，동시이102례정상이생육부녀작위대조조。결과（1）림파세포면역치료전여대조조상비，PD-1화Th2형세포인자（IL-4화IL-10）현저하강（P균＜0.05）。（2）림파세포면역치료후여치료전상비，Th1형세포인자（IL-2화IFN-γ）함량명현하조（P균＜0.05）。（3）림파세포면역치료후여대조조상비，PD-1、Th1/Th2형세포인자수평무현저성차별（P균＞0.05）。（4）URSA환자외주혈PD-1함량화혈청중Th2형세포인자수평정정상관（r＝0.67，r＝0.81，P균＜0.05）；여Th1형세포인자정부상관（r＝-0.55，r＝-0.73，P균＜0.05）。（5）림파세포면역치료후，임신성공적부녀PD-1표체수평현저고우임신실패자（P＜0.05）。결론 PD-1가능통과하조Th1/Th2형세포인자적수평억제URSA적발생발전。
Objective To study the effect of programmed cell death-1 (PD-1) in peripheral blood and T helper-1 type(Th1)/T helper-2 type(Th2) cytokine in serum in patients with unexplained recurrent spontaneous abortion(URSA). Methods Flow cytometry was used to measure the PD-1 of 140 unexplained recurrent spontaneous abortion women before and after lymphocyte immunotherapy;enzyme linked immunosorbant assay(ELISA) was used to measure Th1/Th2 type cytokines of the patients before and after lymphocyte immunotherapy, and control as 102 normal fertile women. Results (1) PD-1 and Th2 type cytokine levels were significantly decreased before the lymphocyte immunotherapy(P<0.05). (2) Th1 type cytokine were significantly down-regulated after the lymphocyte immunotherapy(P<0.05). (3) Compared with control group, PD-1, Th1/Th2 cytokine levels were not significantly different after the lymphocyte immunotherapy(P>0.05). (4) The levels of PD-1 in peripheral blood and Th2-type cytokines in serum with URSA patients were positively correlated (r=0.67, r=0.81, P<0.05);and Th1-type cytokines were negatively correlated (r=-0.55, r=-0.73, P<0.05). (5)The percentage of PD-1 was significantly higher in successful pregnant women than those in pregnant loss after lymphocyte therapy. Conclusion PD-1 may suppress the development of URSA by down-regulating the level of Th1/Th2 cytokines.