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目的:探讨原因不明复发性流产(URSA)患者再次妊娠时不同妊娠结局与外周血中Th1/Th2型细胞因子水平的变化规律。方法:采用酶联免疫吸附法检测:①33例URSA患者、32例正常妊娠及78例正常未孕妇女外周血IL-2、IL-10、IFN-γ、IL-4、IL-6的水平;②回顾性分析23例URSA患者再次正常妊娠前、后外周血IL-2、IL-10、IFN-γ、IL-4、IL-6水平的变化;③URSA患者随访中,44例再次正常妊娠与16例妊娠后再次流产的外周血IL-2、IL-10、IFN-γ、IL-4、IL-6水平的比较。结果:①与正常妊娠组及正常未孕组相比,URSA组外周血中Th1型细胞因子IL-2、IFN-γ的水平升高(P<0.05),Th2型细胞因子IL-10、IL-4、IL-6的水平降低(P<0.05);②URSA患者再次正常妊娠前、后自身对照比较结果显示,Th1型细胞因子IL-2、IFN-γ外周血水平在同一URSA患者妊娠阶段有明显下降(P<0.05),而Th2型细胞因子IL-4则有明显上升(P<0.05);③在URSA患者再次妊娠后,再次流产组Th1型细胞因子IL-2、IFN-γ外周血水平较继续妊娠组高(P<0.05),Th2型细胞因子IL-10、IL-4外周血水平较继续妊娠组低(P<0.05)。结论:URSA患者Th1型细胞因子升高,Th2型细胞因子降低,而URSA患者再次正常妊娠时Th1型细胞因子降低,Th2型细胞因子升高。外周血中Th1/Th2细胞因子的变化与妊娠结局相关。
Objective: To investigate the changes of Th1 / Th2 cytokines in different pregnancy outcomes and peripheral blood in patients with unexplained recurrent spontaneous abortion (URSA). Methods: The levels of IL-2, IL-10, IFN-γ, IL-4 and IL-6 in 33 URSA patients, 32 normal pregnant women and 78 normal pregnant women were detected by enzyme-linked immunosorbent assay ②The changes of IL-2, IL-10, IFN-γ, IL-4 and IL-6 in 23 URSA patients before and after normal pregnancy were retrospectively analyzed; ③ In the follow-up of 44 URSA patients, The levels of IL-2, IL-10, IFN-γ, IL-4 and IL-6 in 16 cases of recurrent miscarriage after pregnancy were compared. Results: ① Compared with normal pregnancy group and normal non-pregnant group, the levels of Th1 cytokines IL-2 and IFN-γ in peripheral blood of URSA group were significantly increased (P <0.05), while those of Th2 type cytokines IL-10 and IL (P <0.05). ②Comparison of self-control before and after normal pregnancy in URSA patients showed that the levels of IL-2 and IFN-γ in peripheral blood of patients with URSA in the same stage of pregnancy were (P <0.05); (3) After the second trimester pregnancy in URSA patients, the level of Th1 cytokine IL-2 and IFN-γ in peripheral blood (P <0.05). The levels of IL-10 and IL-4 in peripheral blood of Th2 type cytokines were lower than those of the continuing pregnancy group (P <0.05). Conclusion: Th1 type cytokines and Th2 type cytokines are decreased in patients with URSA. Th1 type cytokines and Th2 type cytokines are decreased in normal pregnant women with URSA. The change of Th1 / Th2 cytokines in peripheral blood is related to pregnancy outcome.