探讨淋巴细胞免疫治疗对复发性流产（RSA）患者T淋巴细胞亚群分布与程序性细胞死亡受体1（PD1）/配体1（PD-L1）表达的影响及意义。

选取2019年1月至2021年1月在海南医学院第一附属医院接受淋巴细胞免疫治疗的120例RSA患者为研究组，另选同期在本院接受健康体检的120名健康女性为对照组。研究组年龄（28.57±7.22）岁，对照组为（29.55±6.28）岁。采用流式细胞仪检测并比较研究组治疗前后及对照组外周血T淋巴细胞亚群（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）分布和PD1/PD-L1表达水平。

治疗前，研究组T淋巴细胞亚群CD3⁺（62.77%±6.95%比69.02%±7.17%）、CD8⁺（34.16%±4.82%比39.67%±5.06%）均较对照组低，CD4⁺（55.16%±7.11%比47.66%±6.69%）、CD4⁺/CD8⁺（1.62±0.53比1.32±0.40）较对照组偏高，差异均具有统计学意义（均P＜0.05）。治疗后，研究组PD1在T淋巴细胞CD4⁺和CD8⁺表达水平均较对照组低，PD-L1在T淋巴细胞CD4⁺和CD8⁺表达水平亦均较对照组低，差异均有统计学意义（均P＜0.05）。治疗后研究组T淋巴细胞亚群CD3⁺和CD8⁺均较治疗前升高，CD4⁺和CD4⁺/CD8⁺均较治疗前降低，差异均有统计学意义（均P＜0.05）。治疗后研究组PD1在T淋巴细胞CD4⁺和CD8⁺表达水平以及PD-L1在T淋巴细胞CD4⁺表达和CD8⁺表达水平均较治疗前升高，差异均有统计学意义（均P＜0.05）。

与健康女性相比，RSA患者T淋巴细胞亚群分布和PD1/PD-L1表达水平更低，可能参与RSA病情进展。采取淋巴细胞免疫治疗可提高T淋巴细胞亚群分布和PD1/PD-L1表达水平，改善患者免疫状态。

To explore the effect of lymphocyte immunotherapy on the distribution of T lymphocyte subsets and the expression of programmed cell death 1 (PD1)/programmed cell death-ligand 1 (PD-L1) in patients with recurrent spontaneous abortion (RSA).

A total of 120 RSA patients who received lymphocyte immunotherapy at the First Affiliated Hospital of Hainan Medical University from January 2019 to January 2021 were selected as a research group, and another 120 healthy women who underwent physical examination at the hospital during the same period were selected as a control group. The mean age of patients in the research group was (28.57±7.22) years, and it was (29.55±6.28) years in the control group. The distribution of peripheral lymphocyte T subsets (CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ ratio) and PD1/PD-L1 expression levels in the two groups were determined by flow cytometry and compared before and after the treatment.

Before the treatment, the percentages of CD3⁺ and CD8⁺ T lymphocyte subsets in the research group were both lower than those in the control group (62.77%±6.95% vs 69.02%±7.17% and 34.16%±4.82% vs 39.67%±5.06%, respectively, P＜0.05 for both), and the percentage of CD4⁺ T lymphocyte subset and CD4⁺/CD8⁺ ratio were both higher in the research group (55.16%±7.11% vs 47.66%±6.69% and 1.62±0.53 vs 1.32±0.40, respectively, P＜0.05 for both). After the treatment, the PD1 expression levels in CD4⁺ and CD8⁺ T lymphocytes of the research group were significantly lower than those in the control group (P＜0.05 for both). Similarly, the PD-L1 expression levels in CD4⁺ and CD8⁺ T lymphocytes of the research group were also significantly lower than those in the control group (P＜0.05 for both). After the treatment, the percentage of CD3⁺ and CD8⁺ T lymphocyte subsets in the research group showed a significant increase compared to those before treatment, while the percentage of CD4⁺ T lymphocyte subset and CD4⁺/CD8⁺ ratio showed a significant decrease (P＜0.05 for all). After the treatment, both PD1 expression levels in CD4⁺ and CD8⁺ T lymphocytes and PD-L1 expression levels in CD4⁺ and CD8⁺ T lymphocytes of the research group were significantly higher compared to those before treatment (P＜0.05 for all).

Compared to healthy females, patients with RSA have lower percentages of T lymphocyte subpopulations and lower expression levels of PD1/PD-L1, which may be involved in the progression of RSA. Adopting lymphocyte immunotherapy can increase the percentages of T lymphocyte subpopulations and the expression levels of PD1/PD-L1, thereby improving the immune status of the patients.