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目的探讨维生素D受体和稽留流产的免疫相关性。方法选取65例因稽留流产住院的孕妇作为观察组,选取65例非正常分娩流产的孕妇作为对照组,比较两组患者血清维生素D受体水平、细胞因子水平及细胞免疫等之间的差异,分析维生素D受体的免疫相关性。结果观察组患者维生素D受体含量、细胞免疫CD8+水平明显低于对照组,细胞免疫CD4+、CD4+/CD8+水平均高于对照组,差异均有统计学意义(P<0.05)。观察组干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)水平分别为(52.22±2.85)ng/L、(62.34±3.96)pg/ml、(65.34±4.86)ng/L、(22.52±1.67)ng/L,对照组分别为(29.23±1.93)ng/L、(33.24±2.73)pg/ml、(115.42±3.63)ng/L、(39.34±1.43)ng/L;观察组细胞因子IFN-γ、TNF-α水平高于对照组,IL-4、IL-10水平低于对照组,差异均有统计学意义(P<0.05)。维生素D受体水平与细胞免疫(CD4+、CD4+/CD8+)、细胞因子Th1(IFN-γ、TNF-α)水平呈负相关(P<0.05),与细胞免疫(CD8+)、细胞因子Th2(IL-4、IL-10)水平呈正相关(P<0.05)。结论维生素D受体缺乏容易出现稽留流产,Th1/Th2细胞向Th1偏移,且维生素D受体含量与Th1、Th2细胞因子存在良好的相关性。
Objective To investigate the immunological relevance of vitamin D receptor and missed abortion. Methods Sixty-five pregnant women with aborted abortion were selected as the observation group, and 65 pregnant women with abnormal abortion were selected as the control group. The differences of serum vitamin D receptor level, cytokine levels and cellular immunity among the two groups were compared. Analysis of vitamin D receptor immune relevance. Results The levels of vitamin D receptor and CD8 + in the observation group were significantly lower than those in the control group. The levels of CD4 + and CD4 + / CD8 + in the observation group were significantly higher than those in the control group (P <0.05). The levels of IFN-γ, TNF-α, IL-4 and IL-10 in observation group were (52.22 ± L, (2.85) ng / L, (62.34 ± 3.96) pg / ml, (65.34 ± 4.86) ng / L, and (22.52 ± 1.67) ng / L respectively) and (29.23 ± 1.93) ng / (115.42 ± 3.63) ng / L and (39.34 ± 1.43) ng / L, respectively. The levels of IFN-γ and TNF-α in the observation group were higher than those in the control group, while the levels of IL-4 and IL-10 in the observation group were lower than Control group, the difference was statistically significant (P <0.05). The level of vitamin D receptor was negatively correlated with the levels of cellular immunity (CD4 +, CD4 + / CD8 +) and cytokines Th1 (IFN- γ, TNF- α) (P <0.05) -4, IL-10) levels (P <0.05). Conclusions Insufficient abortion is easy to occur in patients with vitamin D receptor deficiency. Th1 / Th2 cells migrate to Th1, and there is a good correlation between vitamin D receptor and Th1 and Th2 cytokines.