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目的分析复发性自然流产(RSA)弓形虫感染妇女外周血、母-胎界面Th1/Th2细胞因子表达情况,探讨其在RSA发病中的意义。方法采用酶联免疫法(ELISA)检测79例RSA育龄期妇女的弓形虫特异性抗体lgG、IgM以及外周血和蜕膜组织液中IL-2、IL-4、IL-10和IFN-γ等细胞因子水平,同时以45名同期正常早孕并人工流产妇女作为对照。结果 RSA组外周血IgG阳性例数、阳性率(22例、27.85%)和IgM阳性例数、阳性率(10例、12.66%)均明显高于人工流产组(5例、11.11%和2例、4.44%)(χ2=4.710、2.113,P均<0.05);RSA新近感染者外周血和蜕膜组织液中IL-2和IFN-γ等细胞因子表达水平明显高于人工流产未感染妇女,而IL-4和IL-10表达水平则明显低于后者(t=2.485～3.042;P均<0.01)。结论 RSA弓形虫感染育龄期妇女外周血和母-胎界面处具有Th1优势状态表达,这可能是导致RSA的重要原因之一。
Objective To analyze the expression of Th1 / Th2 cytokines in peripheral blood and maternal-fetal interface of women with recurrent spontaneous abortion (RSA), and to explore its significance in the pathogenesis of RSA. Methods Serum IL-2, IL-4, IL-10 and IFN-γ of lgG and IgM of Toxoplasma gondii in 79 pregnant women of RSA were detected by enzyme-linked immunosorbent assay (ELISA) Factor level, at the same 45 normal early pregnancy and abortion women as a control. Results The positive rate of IgG in peripheral blood of RSA group (22 cases, 27.85%) and IgM positive cases (10 cases, 12.66%) were significantly higher than those in induced abortion group (5 cases, 11.11% and 2 cases , 4.44%, respectively) (χ2 = 4.710, 2.133, P <0.05). The levels of IL-2 and IFN-γ in peripheral blood and decidual tissue of newly infected RSA patients were significantly higher than those of uninfected women IL-4 and IL-10 expression levels were significantly lower than the latter (t = 2.485 ~ 3.042; P <0.01). Conclusion Toxoplasma gondii infection in women of childbearing age with peripheral blood and maternal-fetal interface with Th1 dominant state expression, which may be one of the important causes of RSA.