外周血Treg细胞与不明原因复发性流产合并不孕患者辅助生殖助孕结局的相关性分析

Correlation between Peripheral Blood Treg Cells and Assisted Reproductive Technology Outcomes in Infertile Patients with Unexplained Recurrent Spontaneous Abortion

摘要: 目的：探讨外周血调节性T细胞(Treg)与不明原因复发性流产(URSA)合并不孕患者助孕结局的相关性。方法：本研究为回顾性病例对照分析，纳入2019年1月至2023年12月期间在本院生殖医学中心就诊的165例URSA合并不孕患者的临床资料，所有患者均行辅助生殖技术(ART)助孕治疗。采用流式细胞术检测外周血Treg细胞相关指标，根据妊娠结局将患者分为活产组(78例)和非活产组(87例)，比较两组基线资料及Treg相关指标的差异，采用单因素及多因素Logistic回归分析各免疫指标与活产结局的关联。结果：单因素分析显示，活产组Treg/Lym水平显著低于非活产组(1.68 ± 0.44 vs 1.86 ± 0.54, P = 0.022)，且该指标升高会显著降低活产概率(OR = 0.483, 95% CI: 0.254~0.916, P = 0.026)。但在校正混杂因素后，其独立预测作用不再显著。结论：本研究表明，在URSA合并不孕患者中，外周血Treg/Lym比率不是其ART妊娠结局的独立预测指标。

Abstract: Objective: To investigate the correlation between peripheral blood regulatory T cells (Treg) and Assisted Reproductive Technology Outcomes in infertile patients with unexplained recurrent spontaneous abortion (URSA). Methods: This retrospective case-control study analyzed clinical data from 165 infertile patients with URSA who underwent assisted reproductive technology (ART) at our reproductive medicine center between January 2019 and December 2023. Peripheral blood Treg cell parameters were measured using flow cytometry. According to pregnancy outcomes, patients were categorized into a live birth group (n = 78) and a non-live birth group (n = 87). Baseline characteristics and Treg-related parameters were compared between the two groups. Univariate and multivariate logistic regression analyses were performed to evaluate the association between immune parameters and live birth outcomes. Results: Univariate analysis showed that the live birth group had a significantly lower level of Treg/Lym than the non-live birth group (1.68 ± 0.44 vs. 1.86 ± 0.54, P = 0.022). An increase in Treg/Lym was associated with a significantly reduced probability of live birth (OR = 0.483, 95% CI: 0.254~0.916, P = 0.026). However, after adjusting for potential confounders, it was no longer an independent predictor of live birth. Conclusion: This study suggests that the peripheral blood Treg/Lym ratio is not an independent predictor of ART outcomes in infertile patients with URSA.