摘要
目的观察不明原因复发性流产(URSA)患者蜕膜及外周血中IL-15、IL-22的表达情况及补肾活血方对其的影响。方法试验一:纳入样本30例,分为实验组(患URSA且妊娠失败)与正常对照组(正常妊娠行人工流产),每组15例;应用RT-PCR法测定两组受试者蜕膜组织中IL-15R和IL-22R的mRNA含量。试验二:将60例患URSA且再次妊娠的患者,随机分为治疗组和对照组,每组30例;治疗组予补肾活血方+地屈孕酮,对照组予地屈孕酮。两组疗程均为4周,观察近期疗效及妊娠结局,比较外周血中IL-15与IL-22水平的变化情况。结果 (1)RT-PCR显示,实验组蜕膜组织中IL-15R、IL-22R的表达较正常对照组明显升高(P<0.05)。(2)治疗前,两组外周血IL-15、IL-22水平差异无统计学意义(P>0.05)。治疗前后组内比较,两组IL-15、IL-22水平均明显降低(P<0.05)。组间治疗后比较,治疗组IL-15、IL-22水平明显低于对照组(P<0.05)。(3)治疗组、对照组总有效率分别为93.33%、73.33%;组间近期疗效比较,治疗组明显优于对照组(P<0.05)。(4)治疗组、对照组流产率分别为6.67%、26.67%;组间流产率比较,治疗组明显低于对照组(P<0.05)。结论 URSA的发生可能与蜕膜中IL-15R和IL-22R的高表达有关。同时,补肾活血方可明显下调URSA患者外周血中IL-15、IL-22的水平,其机制可能是通过调节妊娠期母体免疫耐受,从而有利于妊娠的维持,并减少流产的发生。
Objective To observe the expression of IL-15 and IL-22 in decidua and peripheral blood and the effect of Bushen Huoxue Recipe on it in patients with unexplained recurrent spontaneous abortion(URSA).Methods Trial 1:30 patients were enrolled and assigned into the experimental group(patients with URSA and pregnancy failure)and the normal control group(patients with normal pregnancy and induced abortion),15 patients in each group;and the mRNA levels of IL-15 R and IL-22 R in decidual tissues of the subjects in the two groups were determined by RT-PCR.Trial 2:60 patients with URSA and re-pregnancy were randomly assigned into the treatment group and the control group,30 patients in each group;and the treatment group was treated with Bushen Huoxue Recipe+dydrogesterone,while the control group was treated with dydrogesterone.Both groups were treated for 4 weeks,and the short-term efficacy and pregnancy outcome were observed.Changes in the levels of IL-15 and IL-22 in peripheral blood were compared.Results(1)RT-PCR showed that the expression of IL-15 R and IL-22 R in decidual tissues of subjects in the experimental group was significantly higher than that in the normal control group(P<0.05).(2)There was no significant difference in the levels of IL-15 and IL-22 between the groups before treatment(P>0.05).The levels decreased significantly in both groups before and after treatment(P>0.05).After treatment,the levels were significantly lower in the treatment group than in the control group(P<0.05).(3)The total effective rate was 93.33%and 73.33%in the treatment group and the control group respectively;and the short-term efficacy in the treatment group was significantly superior to that in the control group(P<0.05).(4)The abortion rate was 6.67%and 26.67%in the treatment group and the control group respectively.It was significantly lower in the treatment group than in the control group(P<0.05).Conclusion The occurrence of URSA may be related to the high expression of IL-15R and IL-22R in the decidua.At the same time,Bushen Huoxue Recipe significantly down-regulates the levels of IL-15 and IL-22 in peripheral blood of patients with URSA.The mechanism of action may be regulation of maternal immune tolerance during pregnancy,thereby facilitating maintenance of pregnancy and reducing the incidence of abortion.
作者
冯晓玲
谷玥儒
张杨
FENG Xiaoling;GU Yueru;ZHANG Yang(Second Department of Gynecology,The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin,Heilongfiang Province 150040,China;2017 post-graduate class at Graduate School,Heilongjiang University of Chinese Medicine,Harbin,Heilongjiang Province 150040,China)
出处
《上海中医药杂志》
2019年第2期68-71,共4页
Shanghai Journal of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81574014)
作者简介
冯晓玲,女,博士后,主任医师,主要从事先兆流产、复发性流产等妇产科疾病的临床研究.
