早发性卵巢功能不全患者外周血CD3^+HLA-DR细胞水平与卵巢储备功能的相关性

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实用医学杂志 2019 年第 35 卷第 13 期 The Journa13
·临 床 研 究·
早发性卵巢功能不全患者外周血 CD3+ HLA⁃DR 细胞水平与卵巢储备功能的相关性
宗国霞 1 王威 2 夏宇跃 3 朱丽阳 4 区宇洁 3 林炳耀 2
【关键词】 早发性卵巢功能不全； CD3； HLA⁃DR； 免疫； 卵巢功能
Correlation between peripheral blood CD3 + HLA ⁃ DR cell levels and ovarian reserve function in patients with premature ovarian insufficiency ZONG Guoxia*，WANG Wei，XIA Yuyue，ZHU Liyang，OU Yujie，LIN Bingyao. *Department of Gynecology，Foshan Fourth People′s Hospital，Foshan 528000，China
广东省佛山市第四人民医院 1 妇科，2 检验科，4 药剂科（广东佛山 528000）；3 广州金域医学检验中心（广州 510330）
【摘要】 目的 早发性卵巢功能不全患者（POI）患者外周血 CD3+ HLA⁃DR 细胞水平与自身免疫及卵 巢功能的相关性。方法 选取于 2017 年 3 月至 2018 年 10 月于我院就诊的卵巢早衰患者共 63 例（POI 组）， 选择同期健康育龄女性（对照组）各 40 例作为对照，流式细胞仪检测所有参与者外周血的 CD3+ HLA⁃DR 抗 原和 CD3+、CD4+、CD8+ T 淋巴细胞亚群，检测性激素 6 项（卵泡生成素、黄体生成素、睾酮、孕酮、雌二醇和泌 乳素）、AMH、抑制素 A、抑制素 B 的含量，分析外周血的 CD3+ HLA⁃DR 抗原的表达水平与免疫功能及性激素 等指标的相关性。结果 POI 组的外周血 CD3+ HLA⁃DR 细胞水平显著高于育龄组，且 CD3+和 CD8+细胞表 达水平显著高于育龄组，而 CD4+以及 CD4+/CD8+的水平显著低于育龄组，差异具有统计学意义（P < 0.05）， POI 组性激素中的 FSH、LH 水平显著高于育龄组，而 T、P、E2 和 PRL 显著低于育龄组（P < 0.001）。POI 组的 AMH、INHA 和 INHB 水平均显著低于育龄组（P < 0.05），POI 中的外周血 CD3+ HLA⁃DR 细胞表达水平与自身免 疫指标中 CD3+、CD8+呈显著的正相关，与 CD4+和 CD4+/CD8+的水平呈显著的负相关（P < 0.001），与卵巢存储 功能中的 AMH、INHA 和 INHB 水平均呈显著的负相关（P < 0.001）。结论 早发性卵巢功能不全患者外周血 CD3+ HLA⁃DR 细胞水平与自身免疫功能、性激素水平具有密切的关系，与卵巢存储功能呈显著的负相关。
【Abstract】 Objective To analyze the correlation between CD3+ HLA⁃DR cells in peripheral blood and autoimmune and ovarian function in patients with premature ovarian insufficiency（POI）. Methods A total of 63 patients with premature ovarian failure who were admitted to our hospital from March 2017 to October 2018（POI group）were enrolled，and 40 healthy women of reproductive age（control group）were selected as controls. Flow cytometry was used to detect CD3 + HLA ⁃ DR antigen and CD3 + ，CD4 + ，CD8 + T lymphocyte subsets in peripheral blood of all participants. Six sex hormones（follicle stimulating hormone，luteinizing hormone，testosterone，proges⁃ terone，estradiol and prolactin），AMH，INHA and INHB were detected in the two group. The correlation between the expression level of CD3+ HLA⁃DR antigen in peripheral blood and immune function and sex hormones was analyzed. Results The levels of CD3+ HLA⁃DR cells in the peripheral blood of the POI group were significantly higher than those in the childbearing age group，and the expression levels of CD3+ and CD8+ cells were significantly higher than those of the childbearing age group，while the levels of CD4+ and CD4+/CD8+ were significantly lower than those of the childbearing age group（P < 0.05）. The levels of FSH and LH in sex hormones in POI group were significantly higher than those in childbearing age group，while T，P，E2 and PRL were significantly lower than those in childbearing age group（P < 0.001）. The AMH，INHA and INHB levels in the POI group were significantly lower than those in the childbearing age group（P < 0.05）. The expression level of peripheral blood CD3+ HLA⁃ DR cells in POI was significantly positively correlated with CD3+ and CD8+ in autoimmune indicators，and CD4+ and The level of CD4+/CD8+ was significantly negatively correlated（P < 0.001），and was significantly negatively correlated with AMH，INHA and INHB levels in ovarian storage function（P < 0.001）. Conclusion The levels of CD3+ HLA⁃DR cells in peripheral blood of patients with early⁃onset ovarian insufficiency are closely related to autoimmune function and sex hormone levels ，and have a significant negative correlation with ovarian storage function.