卵巢早衰免疫因素的相关研究

目的:探讨卵巢早衰患者抗核抗体,HLA-DR+细胞水平及定位,分析免疫因素在致病中的意义。方法:应用免疫学实验技术,流式细胞术及免疫双荧光法检测100例卵巢早衰患者,60例低促性腺激素性闭经患者,60例自然绝经妇女,60例正常育龄妇女的抗核抗体、抗双链DNA抗体、ENA多肽抗体系列、CD3+、HLA-DR+、CD3+HLA-DR+细胞水平。结果:①染色体核型正常的卵巢早衰患者抗核抗体阳性率为26.53%(26/98),染色体核型异常的卵巢早衰患者抗核抗体均为阴性。染色体核型正常的卵巢早衰患者抗核抗体阳性率均明显高于低促性腺激素组、自然绝经组、育龄组(P<0.05),未发现有明显的特殊核抗原成分;13例ANA阳性POF患者经治疗后ANA转为阴性;②卵巢早衰患者外周血HLA-DR抗原表达增加,CD3+HLA-DR+(活化T细胞)增加,与自然绝经组和育龄组比较,差异均有显著意义(P=0.001,P=0.003);6例POF患者经激素替代后CD3+HLA-DR+水平未见明显降低。结论:部分染色体核型正常的卵巢早衰患者机体存在免疫系统异常状态,免疫因素可能是染色体核型正常的卵巢早衰患者的致病原因。

Study on the immune factors of premature ovarian failure

Objective:To analyze the importance of immune factor in the course of premature ovarian failure(POF) by testing the level and location of anti-nuclear antibody(ANA) and HLA-DR+ cell in patients with POF.Methods:Flow cytometry and immune fluorescence method were employed to test the level of CD3+,HLA-DR+,CD3+HLA-DR+ cells and immune techniques were employed to test ANA,anti ds-DNA antibody,ENA polypeptide antibody in the subjects including 100 patients with POF,60 cases of postmenopausal women with low gonadotropin,60 cases of healthy postmenopausal women and 60 cases of normal fertile women.Results:①The positive rate of ANA in POF patients with normal karyotype was 26.53%,while the ANA was negative in those with an abnormal karyotype.The positive rate of ANA in POF patients with normal karyotype was significantly higher than that in other groups(P<0.05),no obviously special nuclear antigen components were detected;ANA was negative after treatment in 13 cases of ANA-positive patients with POF.②The expression level of HLA-DR+ antigen and CD3+ HLA-DR+(activated T cells) increased in the patients with POF,compared to the healthy postmenopausal group and normal fertile group,the differences were significant(P=0.001,P=0.003);The level of CD3+ HLA-DR+ wasn't decreased significantly in 6 cases of POF patients with hormone replacement.Conclusion:The immune system is abnormal in some of the patients with POF who are karyotypically normal,immune factors may be the causes of POF patients with normal karyotype.