自然杀伤T细胞在不明原因习惯性流产患者外周血中的表达

目的探讨自然杀伤T细胞(natural killer Tcell,NKT cell)在不明原因习惯性流产(unexplained habitual abortion,UHA)患者外周血中的表达。方法选取2014年11月至2015年10月深圳市宝安区沙井人民医院收治的257例妇女作为研究对象。其中53例UHA未孕患者(A组)、49例UHA难免流产患者(B组)作为病例组;50例无生育史的正常妇女(C组)、50例有生育史的正常妇女(D组)、55例正常妊娠孕妇(E组)作为对照组。研究对象均采集静脉血行流式细胞术检测,观察各组研究对象外周血NKT细胞表达水平。结果 1 E组外周血NKT细胞表达水平显著高于A、B、C、D组(P0.05),D组与C组外周血NKT细胞表达水平比较差异无统计学意义(P0.05),D组、C组外周血NKT细胞表达水平显著高于A组、B组(P0.05),B组外周血NKT细胞表达水平显著高于A组(P0.05)。2绘制外周血NKT细胞表达水平诊断UHA的受试者工作特征曲线(receiver operating characteristic,ROC曲线),得到ROC曲线下面积(area under the ROC curve,AUC)为0.895(95%可信区间为0.754~0.953),最佳诊断阈值为4.68%,其对应的灵敏度、特异度、阳性预测值、阴性预测值、诊断准确度分别为91.18%、90.97%、86.92%、94.00%、91.05%。结论 UHA患者外周血低表达NKT细胞,外周血NKT细胞水平对诊断UHA有一定的临床价值。

Expression of natural killer T cells in peripheral blood of patients with unexplained habitual abortion

Objective To investigate the expression of natural killer T ( NKT) in peripheral blood of patients with unexplained habitual abortion ( UHA) . Methods 257 women were selected from November, 2014 to October, 2015 in Shajing people's Hospital of Baoan District of Shenzhen City as the study subjects. 53 cases of URSA non-pregnant patients(group A) and 49 cases of URSA inevitable abortion patients(group B) were selected as the case group;50 cases of normal women without reproductive history(group C) , 50 cases of normal women with reproductive history( group D) and 55 cases of normal pregnant women( group E) were selected as the control group. Flow cytometry was used to collect venous blood samples. The expression level of NKT cells in the peripheral blood of the study subjects was observed. Results ① The expression level of NKT cells in group E was significantly higher than that in group A, B, C and D, respectively (P<0. 05). There was no significant difference in the expression level of NKT cells between group D and group C. ( P >0. 05 ) . The levels of NKT cells in group D and C were significantly higher than those in group A and B, respectively(P<0. 05). The expression level of NKT cells in group B was significantly higher than that in group A(P<0. 05). ② Draw the receiver operating characteristic ( ROC) curve of the expression of NKT cells in peripheral blood to diagnose UHA. ,the area under the ROC curve (AUC) was 0. 895 (95% confidence interval was 0. 754~0. 953). The best diagnostic threshold was 4. 68%. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 91. 18%, 90. 97%, 86. 92%, 94. 00% and 91. 05% respectively. Conclusion The expression of NKT cells in peripheral blood of patients with UHA was low. The level of NKT cells in peripheral blood have a certain clinical value in diagnosing UHA.