發(fā)布時間：2018-08-26 14:09

【摘要】：目的:子癇前期(preeclampsia PE)是一類以全身小血管痙攣,炎癥反應及腎臟損傷為主要特點的妊娠期特有的并發(fā)癥,初步研究T細胞亞群是否和子癇前期之間的相關(guān)性及不同比例的T細胞亞群對子癇前期患者的腎功及血脂的影響。方法:對于2016年7月-2017年1月期間在大連醫(yī)科大學附屬第一醫(yī)院產(chǎn)科住院的孕婦分組,實驗組子癇前期重度孕婦24例(A組)、子癇前期輕度孕婦21例(B組)及對照組正常妊娠孕婦24例(C組)的臨床資料進行分析,流式細胞術(shù)檢驗所研究的孕婦T細胞亞群的比例,判斷子癇前期與T細胞亞群的相關(guān)性。采用SPSS19.0對研究數(shù)據(jù)進行單因素方差及Pearson相關(guān)系數(shù)檢驗。結(jié)果:1、子癇前期重度組(A組)、子癇前期輕度組(B組)、正常妊娠組(C組)相比較,患者的年齡、孕次的均值水平差異不顯著,組間差異也無統(tǒng)計學意義(均P0.05);子癇前期重度組及子癇前期輕度組的孕齡均值水平與正常妊娠組比較,差異均具有顯著的統(tǒng)計學意義(P0.05),而子癇前期重度組及子癇前期輕度組之間的差異無統(tǒng)計學意義(P0.05)。2、通過流式細胞術(shù)的檢測,發(fā)現(xiàn)子癇前期重度患者CD4+T細胞數(shù)(TH)與子癇前期輕度組及正常妊娠組相比,顯著升高(P0.05),而CD8+T細胞數(shù)(TS)明顯降低,顯著低于正常妊娠組均值水平(P0.05),因而CD4+細胞數(shù)/CD8+細胞數(shù)比值(TH/TS),子癇前期重度組與子癇前期輕度組及正常妊娠組相比,明顯升高(P0.05),同時研究發(fā)現(xiàn)子癇前期重度患者的TH/TS水平顯著高于子癇前期輕度患者的均值水平(P0.05)。3、尿酸水平:子癇前期重度組與子癇前期輕度組、正常妊娠組相比,尿酸均值水平顯著高于正常妊娠組(P0.05),子癇前期輕度組與正常妊娠組相比較,尿酸均值水平相差不大(P0.05);腎小球濾過率(GFR):子癇前期重度組相較于子癇前期輕度組和正常妊娠組而言,GFR均值水平明顯降低(P0.05),而子癇前期輕度組與正常妊娠組之間GFR水平差異不具有統(tǒng)計學意義(P0.05);總膽固醇水平:子癇前期重度組、正常妊娠組及子癇前期輕度組比較,前兩者稍高于后者(P0.05),同時前兩組也高于正常范圍;子癇前期重度組與正常妊娠組之間無顯著性差異(P0.05);甘油三酯水平:三組均值均明顯高于正常范圍,子癇前期重度組、子癇前期輕度組與正常妊娠組(對照組)相比,該指標前兩組明顯高于正常妊娠組(P0.05),而子癇前期重度組該指標均值水平與子癇前期輕度組差異不具有統(tǒng)計學意義(P0.05)。子癇前期重度患者的尿酸、甘油三酯、總膽固醇水平顯著提高,而GFR則顯著下降。4、子癇前期患者血液中尿酸水平與TH具有正相關(guān)關(guān)系,相關(guān)系數(shù)為0.752(P0.05);GFR與TH/TS具有負相關(guān)關(guān)系,相關(guān)系數(shù)為-0.601(P0.05);總膽固醇與TH具有正相關(guān)性(P0.05),相關(guān)系數(shù)為0.707;甘油三酯與TH具有正相關(guān)關(guān)系,相關(guān)系數(shù)為0.590(P0.05),說明T細胞亞群與腎臟損傷及血脂異常緊密相關(guān)。結(jié)論:1、子癇前期與T細胞亞群具有相關(guān)性,子癇前期重度患者TH、TH/TS顯著升高,TS顯著下降。2、子癇前期重度患者的尿酸、總膽固醇、甘油三酯水平顯著升高,腎小球濾過率明顯下降。3、相關(guān)性分析表明,子癇前期重度患者的尿酸、腎小球濾過率、總膽固醇及甘油三酯水平均與T細胞亞群具有相關(guān)性。
[Abstract]:Objective: Preeclampsia PE is a kind of pregnancy-specific complications characterized by systemic vasospasm, inflammation and kidney injury. To study the correlation between T cell subsets and preeclampsia and the effect of different proportion of T cell subsets on renal function and blood lipids in preeclampsia patients. From July 2016 to January 2017, the clinical data of 24 pregnant women with severe preeclampsia (Group A), 21 mild preeclampsia (Group B) and 24 normal pregnant women (Group C) were analyzed. The T lymphocyte subsets of pregnant women were detected by flow cytometry. SPSS19.0 was used to test the single factor variance and Pearson correlation coefficient. Results: 1. Compared with severe preeclampsia group (group A), mild preeclampsia group (group B) and normal pregnancy group (group C), there was no significant difference in the mean level of age and pregnancy between groups. There was no significant difference between severe preeclampsia group and mild preeclampsia group (P 0.05). The mean gestational age of severe preeclampsia group and mild preeclampsia group had significant statistical significance (P 0.05). However, there was no significant difference between severe preeclampsia group and mild preeclampsia group (P 0.05). Compared with mild preeclampsia group and normal pregnancy group, the number of CD4 + T cells (TH) in severe preeclampsia group was significantly higher (P 0.05), while the number of CD8 + T cells (TS) was significantly lower than the mean level of normal pregnancy group (P 0.05), so the ratio of CD4 + cell number to CD8 + cell number (TH / TS), severe preeclampsia group and mild preeclampsia group and normal pregnancy was significantly lower. The levels of TH / TS and uric acid in severe preeclampsia group were significantly higher than those in mild preeclampsia group (P 0.05). The levels of uric acid in severe preeclampsia group were significantly higher than those in mild preeclampsia group and normal preeclampsia group (P 0.05). Compared with normal pregnancy group, the mean level of uric acid was not significantly different (P 0.05); glomerular filtration rate (GFR): Compared with mild preeclampsia group and normal pregnancy group, the mean level of GFR in severe preeclampsia group was significantly lower (P 0.05), but there was no significant difference between mild preeclampsia group and normal pregnancy group (P 0.0). 5) Total cholesterol level: compared with severe preeclampsia group, normal pregnancy group and mild preeclampsia group, the former two groups were slightly higher than the latter (P 0.05), and the former two groups were also higher than the normal range; there was no significant difference between severe preeclampsia group and normal pregnancy group (P 0.05); triglyceride level: the mean values of the three groups were significantly higher than the normal range, preeclampsia group were significantly higher than the normal range. In severe preeclampsia group, the levels of uric acid, triglyceride and total cholesterol in severe preeclampsia group were not significantly different from those in mild preeclampsia group (P 0.05). The serum uric acid level was positively correlated with TH, and the correlation coefficient was 0.752 (P 0.05); GFR was negatively correlated with TH / TS, and the correlation coefficient was - 0.601 (P 0.05); total cholesterol was positively correlated with TH (P 0.05), and the correlation coefficient was 0.707; triglyceride was positively correlated with TH. The coefficient was 0.590 (P 0.05), indicating that T cell subsets were closely related to renal injury and dyslipidemia. Conclusion: 1. Preeclampsia and T cell subsets were correlated. TH, TH / TS in severe preeclampsia patients increased significantly, TS decreased significantly. 2. Uric acid, total cholesterol, triglyceride levels in severe preeclampsia patients increased significantly, glomerular filtration rate was clear. The correlation analysis showed that uric acid, glomerular filtration rate, total cholesterol and triglyceride levels were correlated with T cell subsets in severe pre-eclampsia patients.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R714.244

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