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目的探讨维生素D与稽留流产的免疫相关性。方法选择2013年7月至2014年7月住院治疗的稽留流产患者73例作为观察组,另取同期人工流产的75例正常女性作为对照组。比较两组血清维生素D3水平、细胞免疫(CD4+、CD8+、CD4+/CD8+)及Th1、Th2细胞因子水平差异,分析维生素D与稽留流产的免疫相关性。结果(1)观察组血清维生素D3水平低于对照组[(12.93±1.74)nmol/L vs(19.95±2.99)nmol/L],差异有统计学意义(P<0.01)。(2)观察组CD4+、CD4+/CD8+、IFN-γ、TNF-α水平均高于对照组,CD8+、IL-6、IL-10水平低于对照组,差异均有统计学意义(P均<0.01)。(3)单因素回归分析显示,维生素D3水平与CD4+、CD4+/CD8+、IFN-γ、TNF-α水平呈负相关,与CD8+、IL-6、IL-10水平呈正相关(P均<0.01)。结论稽留流产孕妇维生素D缺乏、细胞免疫功能亢进、辅助性T细胞向Th1细胞偏移,且维生素D3含量与免疫功能存在相关性。
Objective To investigate the immunological relevance of vitamin D and missed abortion. Methods Seventy-three patients with missed abortion admitted to hospital from July 2013 to July 2014 were selected as the observation group. Another 75 normal women with induced abortion during the same period were selected as the control group. The levels of serum vitamin D3, cytokines (CD4 +, CD8 +, CD4 + / CD8 +) and the levels of Th1 and Th2 cytokines were compared between the two groups to analyze the immunological relativity between vitamin D and missed abortion. Results (1) The level of serum vitamin D3 in the observation group was lower than that in the control group [(12.93 ± 1.74) nmol / L vs (19.95 ± 2.99) nmol / L], the difference was statistically significant (P <0.01). (2) The levels of CD4 +, CD4 + / CD8 +, IFN- γ and TNF-α in the observation group were higher than those in the control group, and the levels of CD8 +, IL-6 and IL-10 in the observation group were lower than those in the control group 0.01). (3) Univariate regression analysis showed that the level of vitamin D3 was negatively correlated with the levels of CD4 +, CD4 + / CD8 +, IFN- γ and TNF-α, positively correlated with the levels of CD8 +, IL-6 and IL- . Conclusions The pregnant women with missed abortion have vitamin D deficiency, hyperstimulation of cellular immunity, migration of helper T cells to Th1 cells, and there is a correlation between vitamin D3 content and immune function.