自体PBMCs宫腔灌注治疗原因不明复发性流产及其相关机制-东南大学学报医学版

自体PBMCs宫腔灌注治疗原因不明复发性流产及其相关机制

单位：南方医科大学附属深圳市妇幼保健院, 广东深圳 518000

关键词：原因不明复发性流产外周血单个核细胞白细胞介素-2 白细胞介素-10 干扰素-γ 单核细胞趋化蛋白-1 T细胞活化后表达和分泌的调节蛋白

分类号：R714.21

出版年·卷·期（页码）：2019·38·第四期（699-703）

摘要：

目的：探讨宫腔灌注人绒毛膜促性腺激素（HCG）共培养自体外周血单个核细胞（PBMCs）治疗对原因不明复发性流产（URSA）患者妊娠结局的影响并对其作用机制进行初步研究。方法：选取46例URSA患者，随机选取23例为试验组（另23例作为对照组），进行HCG共培养自体PBMCs宫腔灌注治疗，随访妊娠结局，对其中21例患者宫腔灌注治疗前后取少许子宫内膜组织检测IL-2、IL-10、INF-γ、单核细胞趋化蛋白-1，（MCP-1）、T细胞活化后表达和分泌的调节蛋白（RANTES）的变化。结果：试验组23例患者中9例持续妊娠，妊娠率达到39.13%，显著高于对照组的13.04%（P<0.05）。持续妊娠者宫腔灌注治疗后子宫内膜IL-2、INF-γ、MCP-1的质量浓度较治疗前下降，而IL-10、RANTES的质量浓度较治疗前升高，差异均有统计学意义（P<0.05）；未持续妊娠者治疗前后子宫内膜IL-2、IL-10、INF-γ、MCP-1、RANTES的质量浓度无明显变化（P>0.05）。结论：HCG共培养自体PBMCs宫腔灌注治疗能够改善URSA患者的妊娠结局。

Objective: To investigate the effect of intrauterine administration of hCG-activated autologous PBMCs on pregnancy outcome in patients with URSA and its mechanism. Methods: 46 patients with URSA were allocated into control group and experimental group, the experiment group were treated with intrauterine administration of hCG-activated autologous PBMCs. Their pregnancy outcome was followed up. A few endometrial tissues were taken from 21 patients within experimental group before and after intrauterine perfusion therapy, which were used to detect changes in cytokines of IL-2,IL-10,INF-γ,MCP-1, RANTES. Results: 9 of the 23 patients in the experomental group were pregnant, and the pregnancy rate was 39.13%. In the continuous pregnancy group, the concentration of IL-2,INF-γ and MCP-1 in endometrium after intrauterine infusion were lower than those before treatment, while the concentration of IL-10,RANTES were higher than those before treatment. The difference was statistically significant. The concentrations of IL-2, IL-10,INF-γ and RANTES in unsustained pregnancy group had no significant difference before and after treatment. Conclusion: Intrauterine infusion of of hCG-activated autologous PBMCs can improve the pregnancy outcome of the patients with URSA.

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