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目的探讨自然杀伤T细胞(natural killer Tcell,NKT cell)在不明原因习惯性流产(unexplained habitual abortion,UHA)患者外周血中的表达。方法选取2014年11月至2015年10月深圳市宝安区沙井人民医院收治的257例妇女作为研究对象。其中53例UHA未孕患者(A组)、49例UHA难免流产患者(B组)作为病例组;50例无生育史的正常妇女(C组)、50例有生育史的正常妇女(D组)、55例正常妊娠孕妇(E组)作为对照组。研究对象均采集静脉血行流式细胞术检测,观察各组研究对象外周血NKT细胞表达水平。结果 1 E组外周血NKT细胞表达水平显著高于A、B、C、D组(P<0.05),D组与C组外周血NKT细胞表达水平比较差异无统计学意义(P>0.05),D组、C组外周血NKT细胞表达水平显著高于A组、B组(P<0.05),B组外周血NKT细胞表达水平显著高于A组(P<0.05)。2绘制外周血NKT细胞表达水平诊断UHA的受试者工作特征曲线(receiver operating characteristic,ROC曲线),得到ROC曲线下面积(area under the ROC curve,AUC)为0.895(95%可信区间为0.754~0.953),最佳诊断阈值为4.68%,其对应的灵敏度、特异度、阳性预测值、阴性预测值、诊断准确度分别为91.18%、90.97%、86.92%、94.00%、91.05%。结论 UHA患者外周血低表达NKT细胞,外周血NKT细胞水平对诊断UHA有一定的临床价值。
Objective To investigate the expression of natural killer T cell (NKT cell) in peripheral blood of patients with unexplained habitual abortion (UHA). Methods A total of 257 women admitted to Shajing People’s Hospital of Bao’an District from November 2014 to October 2015 were selected as research subjects. Among them, 53 cases of uninfected UHA patients (group A) and 49 cases of UHA (B group) were considered as cases; 50 cases of normal pregnant women (group C), 50 cases of normal pregnant women (group D) ), 55 cases of normal pregnant women (group E) as a control group. The subjects were collected venous blood flow cytometry detection, observation of peripheral blood NKT cell expression levels in each group. Results The expression level of NKT cells in peripheral blood of group E was significantly higher than that of group A, B, C, D (P <0.05), while there was no significant difference in the expression of NKT cells between group D and C (P> 0.05) The expression of NKT in peripheral blood of group D and group C was significantly higher than that of group A and B (P <0.05). The expression of NKT in peripheral blood of group B was significantly higher than that of group A (P <0.05). 2 Mapping peripheral blood NKT cell expression The receiver operating characteristic (ROC curve) of subjects diagnosed with UHA obtained an area under the ROC curve (AUC) of 0.895 (95% confidence interval 0.754 ~ 0.953). The best diagnostic threshold was 4.68%. The corresponding sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 91.18%, 90.97%, 86.92%, 94.00% and 91.05% respectively. Conclusions The expression of NKT cells in peripheral blood of patients with UHA and the level of NKT in peripheral blood have some clinical value in the diagnosis of UHA.