摘要： 目的 探讨复发性流产（RSA）患者早孕期外周血自然杀伤（NK）细胞及NKG2C⁺NK细胞比例，为RSA发病机制的研究提供参考。方法 选择2018年9月至2019年11月就诊于中国医科大学附属盛京医院产科门诊的早孕期RSA患者57例及正常孕妇30例（正常对照组）。根据此次妊娠是否发生自然流产，将RSA患者分为RSA流产组（15例）与RSA妊娠组（42例）。收集早孕期肘静脉血，流式细胞术检测NK、CD56^dimCD16⁺NK、CD56^brightCD16^-NK及NKG2C⁺NK细胞百分比。结果 RSA流产组总NK细胞百分比（15.66%±5.07%）明显高于RSA妊娠组（11.97%±3.89%）及正常对照组（13.76%±5.85%）（P<0.05）；RSA流产组NK细胞CD56^dimCD16⁺亚群百分比（93.09%±3.69%）虽高于RSA妊娠组（91.66%±5.32%）及正常对照组（90.18%±7.81%），但差异无统计学意义（P>0.05）；RSA流产组NK细胞CD56^brightCD16^-亚群百分比（3.32%±2.14%）低于RSA妊娠组（4.92%±2.85%）及正常对照组（3.65%±2.19%）（P<0.05）；RSA流产组NKG2C⁺NK细胞百分比（24.23%±5.65%）比RSA妊娠组（11.83%±2.54%）及正常对照组（14.45%±1.92%）显著增高（P<0.05）。结论 RSA患者外周血NK细胞百分比变化及NKG2C⁺NK细胞增多可能导致免疫平衡失调，引起自然流产。

外周血NK及NKG2C⁺NK细胞比例变化与复发性流产的关系

刘倩^1,2,3, 侯悦^1,2,3, 金大中^1,2,3, 乔宠^1,2,3

1. 中国医科大学附属盛京医院妇产科, 沈阳 110004;
2. 辽宁省母胎医学重点实验室, 辽宁 本溪 117000;
3. 辽宁省高校妇产科重点实验室, 辽宁 本溪 117000

收稿日期:2020-03-24出版日期:2020-12-30发布日期:2020-12-09
通讯作者:乔宠E-mail:qiaochong2002@163.com
作者简介:刘倩(1994-),女,硕士研究生.
基金资助:国家重点研发计划（2016YFC1000404）；国家自然科学基金（81771610）；盛京自由研究者基金（201706）；辽宁省****项目（2017）


关键词: 复发性流产, 自然杀伤细胞, NKG2C
Abstract: Objective To explore the subsets of natural killer (NK) cells and the proportion of NKG2C⁺NK cells in peripheral blood of patients with recurrent spontaneous abortion (RSA) in early pregnancy,and thus provide a reference for future research on RSA pathogenesis. Methods From September 2018 to November 2019,57 RSA patients and 30 normal pregnant women in early pregnancy were selected from the obstetrics clinic of Shengjing Hospital of China Medical University. RSA patients were classified according to whether the pregnancy was lost into the abortion group (n=15) or the pregnancy group (n=42). Elbow venous blood was collected from the three groups during early pregnancy. Flow cytometry was used to detect NK,CD56^dimCD16⁺NK,CD56^brightCD16^-NK,and NKG2C⁺NK cells. Results The percentage of total NK cells in the RSA abortion group (15.66%±5.07%) was significantly higher than those in the RSA pregnancy group (11.97%±3.89%) and the normal early pregnancy group (13.76±5.85%) (P<0.05). Although the proportion of NK cell subset CD56^dimCD16⁺NK (93.09%±3.69%) in RSA abortion group was higher than those in the RSA pregnancy group (91.66%±5.32%) and the normal early pregnancy group (90.18%±7.81%),the difference was not statistically significant (P>0.05). The RSA abortion group had a lower percentage of NK cell subset CD56^brightCD16^- NK (3.32%±2.14%) than the RSA pregnancy (4.92%±2.85%) and the normal early pregnancy (3.65%±2.19%) groups (P<0.05). The percentage of NKG2C⁺NK cells in the RSA abortion group (24.23%±5.65%) was significantly higher than those in the RSA pregnancy (11.83%±2.54%) and the normal early pregnancy (14.45%±1.92%) groups (P<0.05). Conclusion Increased NK and NKG2C⁺NK cells in RSA patients may lead to an immune imbalance that causes spontaneous abortion. The specific mechanisms needs to be further elucidated.
Key words: recurrent spontaneous abortion, natural killer cells, NKG2C
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