中间型单核细胞在妊娠妇女子痫前期病情过程中的变化及临床意义

Changes and clinical significance of intermediate mononuclear cells in preeclampsia among pregnant women

摘要:

目的：探讨中间型单核细胞在妊娠妇女子痫前期病情过程中的变化及临床意义。方法：以64例确诊为子痫前期的妊娠妇女作为子痫前期组；以64例产前检查的孕周与子痫前期组相似的正常妊娠妇女作为对照组。子痫前期组妊娠妇女于入院时，健康妊娠妇女于相似孕周产前检查时采集肘静脉血进行流式细胞技术及血清细胞因子水平检测。结果：与对照组相比，子痫前期妊娠妇女的中间型与非经典型单核细胞比例明显增高，经典型单核细胞比例明显降低（P<0.01）；29例早发型子痫前期妊娠妇女中间型单核细胞的比例明显低于35例晚发型子痫前期妊娠妇女（P<0.01）；子痫前期组妊娠妇女中间型单核细胞表面Toll 样受体（Toll like receptor，TLR）4、CD64阳性细胞比例明显高于对照组（P<0.01）；子痫前期组妊娠妇女中间型单核细胞表面表面髓系细胞触发受体-1（triggering receptor expressed on myeloid cell-1，TREM-1）、TLR4、CD64平均荧光强度明显高于对照组（P<0.01）；子痫前期组妊娠妇女之间的中间型单核细胞内肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白介素（interleukin，IL）-6平均荧光强度均明显高于对照组（P<0.01）；子痫前期组妊娠妇女血清TNF-α、IL-6、IL-8水平明显高于对照组（P<0.01）；子痫前期组妊娠妇女中间型单核细胞与TNF-α、IL-6呈明显正相关关系（P<0.05）；对照组二者之间无明显相关关系。结论：子痫前期妊娠妇女外周血中的中间型单核细胞比例明显增高，中间型单核细胞表面TREM-1、TLR4、CD64高度表达，血清TNF-α、IL-6水平明显上升，可能与中间型单核细胞参与妊娠妇女子痫前期病情过程有关。

Abstract:

Objective：To investigate the changes and clinical significance of intermediate mononuclear cells in preeclampsia in preg－nant women. Methods：Totally 64 preeclampsia women were selected as preeclampsia group. Sixty-four normal pregnant women of prenatal examination were taken as the control group. The pregnant women in the pre-eclampsia group were admitted to hospital. The blood samples of elbow vein were collected during antenatal examination of similar gestational weeks for flow cytometry and serum cytokine levels in healthy pregnant women. Results：Compared with those of control group，the proportion of intermediate and non-classical monocytes in preeclampsia pregnant women was significantly increased，and the proportion of classic monocytes was signifi－cantly decreased（P<0.01）. The percentage of intermediate monocytes in 29 cases of early preeclampsia was significantly lower than that in 35 cases of late preeclampsia（P<0.01）. The percentage of Toll like receptor（TLR）4，CD64 positive cells on the surface of in－termediate monocytes in preeclampsia group was significantly higher than that in control group（P<0.01）. In preeclampsia group，the average fluorescence intensity of triggering receptor expressed on myeloid cell-1（TREM-1）/TLR4 CD64 was significantly higher than that of control group（P<0.01）. The mean fluorescence intensity of tumor necrosis factor-α（TNF-α），interleukin（IL）-6 in interme－diate monocytes in preeclampsia group was significantly higher than that in control group（P<0.01）. The serum levels of TNF-α IL-6 and IL-8 in preeclampsia group were significantly higher than those in control group（P<0.01）. Mesenchymal monocytes and TNF-α in preeclampsia group（P<0.05）. There was no signifi－cant correlation between two projects in the control group. Conclusion：The proportion of intermediate monocytes in the peripheral blood of preeclampsia women is significantly increased，the expression of TREM-1，TLR4，CD64 on the surface of TREM-1，TLR4，CD64 are high，and the level of serum TNF-α/IL-6 is significantly increased，which may be involved in the process of preeclampsia in women with preeclampsia.