【摘要】 目的 探讨高龄女性妊娠早期先兆流产患者血清自然杀伤（natural killer,NK）细胞、白细胞介素-2(interleukin-2,IL-2)、γ-干扰素（interferon-γ,IFN-γ）水平的变化及其对妊娠结局等相关因素的影响。方法纳入2017年1月至2020年1月厦门市中医院收治的高龄女性早期先兆流产患者61例设为观察组，另外纳入同期在我院产检的健康高龄早孕妇女52例设为对照组。两组均随访至产后。比较两组外周血NK细胞、IL-2、IFN-γ水平，比较观察组的孕次、流产次数、妊娠结局与外周血NK细胞、IL-2、IFN-γ的关系。采用t检验、Kruskal-Wallis H以及二项分布Logistic回归进行统计学分析。结果 (1)两组一般临床资料比较，差异无统计学意义（P>0.05）。(2)观察组外周血NK细胞百分比（16.5±7.6）%、IFN-γ(18.2±1.4)ng/L均高于对照组，差异有统计学意义（P<0.05）。外周血NK细胞百分比、IFN-γ浓度每上升1个单位，先兆流产发生率分别增加1.09、1.34倍。(3)观察组中成功分娩43例，流产18例。妊娠结局与NK细胞差异有统计学意义（P<0.05），与IL-2、IFN-γ差异无统计学意义（P>0.05）。(4) NK细胞、IL-2、IFN-γ水平与孕次无明显相关关系（P>0.05）。IL-2、IFN-γ水平与流产次数无明显相关关系（P>0.05）。流产次数≥3次的患者外周血NK细胞水平高于流产次数为0、1、2次的患者，差异有统计学意义（P<0.05）。结论 外周血NK细胞百分比、IFN-γ浓度与先兆流产的发生密切相关；外周血NK细胞水平与流产次数相关。更多还原

【Abstract】 Objective To explore the changes of peripheral blood natural killer(NK) cells,interleukin-2(IL-2) and interferon(IFN-γ) levels in elderly patients with early threatened abortion and their influence on pregnancy outcome.Methods From January 2017 to January 2020 in Xiamen Hospital of Traditional Chinese Medicine,61 elderly patients with early threatened abortion were selected as observation group,52 elderly health-pregnant women at prenatal visit were selected as control group.Both groups were followed up to pregnancy.The indexes of peripheral blood NK cells,IL-2,IFN-γ levels were compared between two groups,and the relationship between gravida,abortion,pregnancy outcome and peripheral blood NK cells,IL-2,IFN-γ were observed of observation group.T test,Kruskal-Wallis H and binomial Logistic regression were used for statistical analysis.Results ① No statistical difference was found in the general clinical data of the two groups(P<0.05).②The percentage of peripheral blood NK cells(16.5±7.6)% and IFN-γ(18.2±1.4) ng/L in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).For each unit increase in the percentage of peripheral blood NK cells and IFN-y concentration,the incidence of threatened abortion was 1.09-fold and 1.34-fold,respectively.③In the observation group,43 cases delivered successfully and 18 cases miscarried.There were statistically significant differences between pregnancy outcomes and NK cells(P<0.05),but no statistically significant differences between pregnancy outcomes and IL-2 and IFN-γ(P>0.05).④There was no significant correlation between NK cells,IL-2,IFN-γ levels and gestational times(P>0.05).The levels of IL-2 and IFN-γ were not significantly correlated with the times of abortion(P>0.05).Peripheral blood NK cell levels of patients with times of abortion≥3 were higher than those with times of abortion 0/1/2,there was statistically significant difference(P<0.05).Conclusions The percentage of peripheral blood NK cells and IFN-γ concentration are closely related to the occurrence of threatened abortion.The level of NK cells in peripheral blood is related to the time s of abortions.更多还原