Objective To investigate the changes and signifcance of peripheral blood Th17 ,CD4+CD25+ iTreg cells and the related cytokines (IL‐17 ,IL‐21 ,IL‐10 ) and TGF‐βin the patients with severe preeclampsia (sPE) .Meth‐ods 30 sPE patients(sPE group) and 30 cases of normal pregnancy(control group) were selected as the research subjects .The levels of Th17 and CD4+CD25+ Treg cells in peripheral blood were detected by flow cytometry .QRT‐PCR was used to detect the mRNA expression level of RORγt and Foxp3 .Plasma cytokines levels of IL‐17 ,IL‐21 ,IL‐10 and TGF‐βwere measured by ELISA .Results The peripheral blood Th17 cells level in the sPE group was signif‐cantly higher than that in the control group ,the difference was statistically significant [(1 .16 ± 0 .78)% vs .(0 .68 ± 0 .35)% ,t=3 .447 ,P=0 .002] .The level of peripheral blood CD4+ CD25+ Treg cells in the sPE group was lower than that in the control group ,the difference was statistically significant [(1 .65 ± 0 .49)% vs .(2 .42 ± 0 .91)% , t= -4 .25 ,P=0 .000] .The expressions level of RORγt mRNA in the sPE group was higher than that in the control group ,the difference was statistically significant [(0 .190 ± 0 .063) vs .(0 .136 ± 0 .037) ,t= 3 .776 ,P=0 .001] ,but the expression level of Foxp3 mRNA was decreased compared with the control group ,the difference was statistically significant[(0 .069 ± 0 .025) vs .(0 .127 ± 0 .027) ,t= -8 .218 ,P=0 .000] .Plasma levels of IL‐17 ,IL‐21 and IL‐10 in the sPE group were (82 .03 ± 37 .61) ,(63 .29 ± 27 .42) ,(56 .89 ± 17 .28)ng/L respectively ,which were higher than (30 .81 ± 21 .87) ,(33 .87 ± 13 .73) ,(33 .24 ± 11 .93) ng/L in the control group respectively ,the differences were sta‐tistically significant(P<0 .01) .However ,the TGF‐β level in the sPE group was markedly decreased compared with the control group ,the difference was statistically significant [(24 .34 ± 6 .51)ng/L vs .(46 .97 ± 15 .81)ng/L ,t= -7 .781 ,P=0 .000] .Plasma IL‐17 and IL‐21 levels in the sPE patients were positively correlated with the Th 17 cells level(r=0 .695 ,0 .586 ,P<0 .01) .Conclusion Th17 cells increase ,CD4+CD25+ Treg cells decrease and related cytokines disorder in the sPE patients could play an important role in the pathogenesis of sPE .%目的：探讨重度子痫前期（sPE）患者外周血 Th17及CD4＋ CD25＋ Treg细胞及相关细胞因子白细胞介素（IL）‐17、IL‐21、IL‐10和转化生长因子β（TGF‐β）的水平变化及意义。方法选取30例sPE患者（sPE组）及30例正常妊娠者（对照组）作为研究对象。采用流式细胞术检测外周血单个核细胞中 T h17及CD4＋ CD25＋ T reg细胞水平。采用 QRT‐PCR检测维甲酸相关孤儿受体γt （RORγt）mRNA 和 Foxp3 mRNA 的表达水平。采用ELISA法检测血浆IL‐17、IL‐21、IL‐10和TGF‐β水平。结果 sPE组外周血Th17细胞水平为（1．16±0．78）％，显著高于对照组的（0．68±0．35）％，差异有统计学意义（t＝3．447，P＝0．002）。sPE组外周血CD4＋CD25＋ Treg细胞水平为（1．65±0．49）％，显著低于对照组的（2．42±0．91）％，差异有统计学意义（t＝－4．25，P＝0．000）。sPE组RORγt mRNA表达水平为0．190±0．063，高于对照组的0．136±0．037，差异有统计学意义（t＝3．776，P＝0．001）。而sPE组Foxp3 mRNA表达水平为0．069±0．025，低于对照组的0．127±0．027，差异有统计学意义（t＝－8．218， P＝0．000）。sPE组IL‐17、IL‐21、IL‐10水平分别为（82．03±37．61）、（63．29±27．42）、（56．89±17．28）ng／L ，高于对照组的（30．81±21．87）、（33．87±13．73）、（33．24±11．93）ng／L ，差异有统计学意义（P＜0．01），TGF‐β水平为（24．34±6．51）ng／L ，低于对照组的（46．97±15．81）ng／L ，差异有统计学意义（t＝－7．781，P＝0．000）。sPE患者血浆IL‐17、IL‐21水平与Th17细胞水平呈正相关（r分别为0．695、0．586，P＜0．01）。结论 sPE患者 Th17细胞数量升高，CD4＋CD25＋ T reg细胞数量减少，以及相关细胞因子的紊乱在sPE的发病机制中可能起到重要作用。
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