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 Hu
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)
