子痫前期患者子宫蜕膜自然杀伤细胞的表型研究

姜妮娜

(青岛市胶州中心医院, 山东 青岛 266300)

【摘要】目的观察先兆子痫患者子宫蜕膜自然杀伤细胞(dNK细胞)的表型。方法选取2012年12月至2013年5月在我院产科住院的30例子痫前期患者作为病例组，随机选取同期在我院产前检查正常的晚期妊娠妇女30例作为正常对照组。收集孕晚期子宫蜕膜组织，机械研磨加梯度离心法提取蜕膜内单核细胞，流式细胞技术(FCM)筛选出dNK细胞，并检测dNK细胞表面CD56及CD16的表达情况。结果病例组与正常对照组CD56bright CD16- CD3- dNK细胞的数量均明显多于CD56dim CD16+ CD3- dNK细胞(P<0.05)，病例组与正常对照CD56bright CD16- CD3- dNK细胞所占比例无显著差异(P>0.05)，CD56dim CD16+ CD3- dNK 细胞所占比例也无显著差异(P>0.05)。结论先兆子痫患者与正常孕妇孕晚期子宫蜕膜内dNK细胞表型没有明显不同，均以CD56bright CD16- CD3-亚型为主。

【关键词】子痫前期； 子宫蜕膜； 自然杀伤细胞； 细胞表型； 母-胎界面

【中图分类号】R 714.24+5【文献标志码】A

收稿日期：( 2014-02-10； 编辑： 张文秀)

Study on phenotype of decidual NK cells in preeclampsia patientsJIANG Nina

(DepartmentofObstetrics,JiaozhouCentralHospitalofQingdao,Qingdao266300,Shandong,China)

Abstract【】ObjectiveTo investigate the phenotype of uterine decidual natural killer cells(dNK cells) in preeclampsia patients. Methods30 women with preeclampsia were selected as case group. 30 normal pregnant women were selected as normal control group. The decidual tissues were sampled immediately after caesarean section. The mononuclear cells were extracted from the tissues by means of mechanic grinding and gradient centrifugation. The technique of flow cytometry was used for dNK cell sorting and the expression of CD56 and CD16 on the surface of cells was also examined. ResultsIn case group and normal control group, the proportions of CD56bright CD16- CD3- dNK cells were significantly higher than those of CD56dim CD16+ CD3- dNK cells(P<0.05). Neither the CD56bright CD16- CD3- subtype nor the CD56dim CD16+CD3- subtype had statistical difference between case group and normal control group(P>0.05). ConclusionThe phenotypes of dNK cells from the women with preeclampsia and from healthy pregnant women are both dominated by CD56bright CD16- CD3- subtype, without significant difference.

【Key words】Preeclampsia; Uterine decidua; Natural killer cells; Cell phenotype; Maternal-feta linter face

子痫前期是孕妇妊娠期特有的严重并发症之一。在我国人群中发病率高达9.4%，直接影响母儿结局，危害母婴健康，但其发病原因和机制尚不清晰。研究表明，该病的发生与母体免疫系统功能混乱有关[1-2]。母-胎界面的局部免疫微环境在妊娠的发生和维持以及临产的发动中发挥重要作用。子宫蜕膜自然杀伤细胞(decidual natural killer cells, dNK cells)是母-胎界面最主要的免疫细胞[3]，在局部发挥重要的免疫调节作用，主要包括两种表型：CD56brightCD16-CD3-和CD56dimCD16+CD3-，两者的平衡是正常妊娠的重要因素，已知正常妊娠者体内的dNK细胞以CD56brightCD16-CD3-亚型为主[4]。子痫前期患者的蜕膜局部免疫微环境变化可能导致免疫耐受失衡而影响妊娠，Wilczynski等[5]称子痫前期患者dNK表型存在变化，CD56dimCD16+CD3-亚型增加，而周等[6]称dNK细胞表型并未改变。顾……