CAJ | 학술논문

目的：探讨重度子痫前期（sPE）患者外周血 Th17及CD4＋ CD25＋ Treg细胞及相关细胞因子白细胞介素（IL）‐17、IL‐21、IL‐10和转化生长因子β（TGF‐β）的水平变化及意义。方法选取30例sPE患者（sPE组）及30例正常妊娠者（对照组）作为研究对象。采用流式细胞术检测外周血单个核细胞中 T h17及CD4＋ CD25＋ T reg细胞水平。采用 QRT‐PCR检测维甲酸相关孤儿受体γt （RORγt）mRNA 和 Foxp3 mRNA 的表达水平。采用ELISA法检测血浆IL‐17、IL‐21、IL‐10和TGF‐β水平。结果 sPE组外周血Th17细胞水平为（1．16±0．78）％，显著高于对照组的（0．68±0．35）％，差异有统计学意义（t＝3．447，P＝0．002）。sPE组外周血CD4＋CD25＋ Treg细胞水平为（1．65±0．49）％，显著低于对照组的（2．42±0．91）％，差异有统计学意义（t＝－4．25，P＝0．000）。sPE组RORγt mRNA表达水平为0．190±0．063，高于对照组的0．136±0．037，差异有统计学意义（t＝3．776，P＝0．001）。而sPE组Foxp3 mRNA表达水平为0．069±0．025，低于对照组的0．127±0．027，差异有统计学意义（t＝－8．218， P＝0．000）。sPE组IL‐17、IL‐21、IL‐10水平分别为（82．03±37．61）、（63．29±27．42）、（56．89±17．28）ng／L ，高于对照组的（30．81±21．87）、（33．87±13．73）、（33．24±11．93）ng／L ，差异有统计学意义（P＜0．01），TGF‐β水平为（24．34±6．51）ng／L ，低于对照组的（46．97±15．81）ng／L ，差异有统计学意义（t＝－7．781，P＝0．000）。sPE患者血浆IL‐17、IL‐21水平与Th17细胞水平呈正相关（r分别为0．695、0．586，P＜0．01）。结论 sPE患者 Th17细胞数量升高，CD4＋CD25＋ T reg细胞数量减少，以及相关细胞因子的紊乱在sPE的发病机制中可能起到重要作用。
목적：탐토중도자간전기（sPE）환자외주혈 Th17급CD4＋ CD25＋ Treg세포급상관세포인자백세포개소（IL）‐17、IL‐21、IL‐10화전화생장인자β（TGF‐β）적수평변화급의의。방법선취30례sPE환자（sPE조）급30례정상임신자（대조조）작위연구대상。채용류식세포술검측외주혈단개핵세포중 T h17급CD4＋ CD25＋ T reg세포수평。채용 QRT‐PCR검측유갑산상관고인수체γt （RORγt）mRNA 화 Foxp3 mRNA 적표체수평。채용ELISA법검측혈장IL‐17、IL‐21、IL‐10화TGF‐β수평。결과 sPE조외주혈Th17세포수평위（1．16±0．78）％，현저고우대조조적（0．68±0．35）％，차이유통계학의의（t＝3．447，P＝0．002）。sPE조외주혈CD4＋CD25＋ Treg세포수평위（1．65±0．49）％，현저저우대조조적（2．42±0．91）％，차이유통계학의의（t＝－4．25，P＝0．000）。sPE조RORγt mRNA표체수평위0．190±0．063，고우대조조적0．136±0．037，차이유통계학의의（t＝3．776，P＝0．001）。이sPE조Foxp3 mRNA표체수평위0．069±0．025，저우대조조적0．127±0．027，차이유통계학의의（t＝－8．218， P＝0．000）。sPE조IL‐17、IL‐21、IL‐10수평분별위（82．03±37．61）、（63．29±27．42）、（56．89±17．28）ng／L ，고우대조조적（30．81±21．87）、（33．87±13．73）、（33．24±11．93）ng／L ，차이유통계학의의（P＜0．01），TGF‐β수평위（24．34±6．51）ng／L ，저우대조조적（46．97±15．81）ng／L ，차이유통계학의의（t＝－7．781，P＝0．000）。sPE환자혈장IL‐17、IL‐21수평여Th17세포수평정정상관（r분별위0．695、0．586，P＜0．01）。결론 sPE환자 Th17세포수량승고，CD4＋CD25＋ T reg세포수량감소，이급상관세포인자적문란재sPE적발병궤제중가능기도중요작용。
Objective To investigate the changes and signifcance of peripheral blood Th17 ,CD4+CD25+ iTreg cells and the related cytokines (IL‐17 ,IL‐21 ,IL‐10 ) and TGF‐βin the patients with severe preeclampsia (sPE) .Meth‐ods 30 sPE patients(sPE group) and 30 cases of normal pregnancy(control group) were selected as the research subjects .The levels of Th17 and CD4+CD25+ Treg cells in peripheral blood were detected by flow cytometry .QRT‐PCR was used to detect the mRNA expression level of RORγt and Foxp3 .Plasma cytokines levels of IL‐17 ,IL‐21 ,IL‐10 and TGF‐βwere measured by ELISA .Results The peripheral blood Th17 cells level in the sPE group was signif‐cantly higher than that in the control group ,the difference was statistically significant [(1 .16 ± 0 .78)% vs .(0 .68 ± 0 .35)% ,t=3 .447 ,P=0 .002] .The level of peripheral blood CD4+ CD25+ Treg cells in the sPE group was lower than that in the control group ,the difference was statistically significant [(1 .65 ± 0 .49)% vs .(2 .42 ± 0 .91)% , t= -4 .25 ,P=0 .000] .The expressions level of RORγt mRNA in the sPE group was higher than that in the control group ,the difference was statistically significant [(0 .190 ± 0 .063) vs .(0 .136 ± 0 .037) ,t= 3 .776 ,P=0 .001] ,but the expression level of Foxp3 mRNA was decreased compared with the control group ,the difference was statistically significant[(0 .069 ± 0 .025) vs .(0 .127 ± 0 .027) ,t= -8 .218 ,P=0 .000] .Plasma levels of IL‐17 ,IL‐21 and IL‐10 in the sPE group were (82 .03 ± 37 .61) ,(63 .29 ± 27 .42) ,(56 .89 ± 17 .28)ng/L respectively ,which were higher than (30 .81 ± 21 .87) ,(33 .87 ± 13 .73) ,(33 .24 ± 11 .93) ng/L in the control group respectively ,the differences were sta‐tistically significant(P<0 .01) .However ,the TGF‐β level in the sPE group was markedly decreased compared with the control group ,the difference was statistically significant [(24 .34 ± 6 .51)ng/L vs .(46 .97 ± 15 .81)ng/L ,t= -7 .781 ,P=0 .000] .Plasma IL‐17 and IL‐21 levels in the sPE patients were positively correlated with the Th 17 cells level(r=0 .695 ,0 .586 ,P<0 .01) .Conclusion Th17 cells increase ,CD4+CD25+ Treg cells decrease and related cytokines disorder in the sPE patients could play an important role in the pathogenesis of sPE .