摘要
目的通过观察反复种植失败患者种植窗期HCG宫腔灌注后CD56＋CD16-和CD56＋CD16＋NK细胞百分比的变化,探讨HCG改变母胎界面的免疫微环境,介导免疫耐受的机制,进而为反复种植失败患者宫腔灌注HCG治疗提供理论依据。方法随机选择2013年1月～2015年1月在吉林省人民医院生殖中心行辅助助孕反复胚胎种植失败的患者共42例,实验组（宫腔灌注HCG组）21例：在自然周期/促排周期排卵后3 d或激素替代周期黄体酮注射后3 d用移植管宫腔灌注重组HCG 500 IU,3 d后取内膜组织,分离NK细胞。分别用流式细胞仪鉴定计数CD56＋CD16-NK细胞和CD56＋CD16＋NK细胞。对照组21例（单纯机械刺激组）：自然周期/促排周期排卵后3 d或激素替代周期黄体酮注射后3 d用移植管单纯行预移植,3 d后取内膜组织,分离NK细胞。分别用流式细胞计数CD56＋CD16-NK细胞和CD56＋CD16＋NK细胞。结果实验组CD56＋CD16-NK细胞百分比高于对照组,差异有统计学意义。结论宫腔灌注HCG能提高反复种植失败患者种植窗期子宫内膜局部CD56＋CD16-NK细胞百分比,诱导免疫耐受、进而提高子宫内膜容受性,促进胚胎植入。
ObjectiveThrough the observation window of repeated failure patients grow period of uterine cavity perfusion after HCG a and CD56＋CD16- and CD56＋CD16＋ NK cells percentage changes, to observe the change of HCG maternal-fetal interface immune microenvironment, mediated immune tolerance mechanism, thus for failure caused by intrauterine infusion in patients with repeated HCG provide theoretical basis for treatment. Methods A total of 42 patients with planting failed repeatedly were selected at random of the reproductive center line auxiliary assisted embryo between January 2013 and January 2015 in Jilin province people＇s hospital, the experimental group of uterine cavity perfusion （HCG） 21 cases： in the natural cycle/promote row cycle ovulation or progestin hormone-replacement cycle 3 days after injection with 3 days after transplantation of uterine cavity perfusion tube restructuring HCG 500 IU, three days after endometrial tissue, separation of NK cells. Cells with the identification of counting CD56＋CD16- NK cells and CD56＋CD16＋ NK cells. Control group 21 cases （pure mechanical stimulation group） ： natural cycle/promote row cycle ovulation or progestin hormone-replacement cycle 3 days after injection tube with 3 days after transplantation pure line pre transplant, 3 days after endometrial tissue, separation of NK cells. With flow cytometry CD56＋CD16- NK cells and CD56＋CD16＋ NK cells. Results The experimental group CD56＋CD16- NK cells percentage is higher than the control group, the difference was statistically significant. Conclusion Uterine cavity perfusion conclusion HCG can improve plant failed repeatedly planting window phase of endometrium in patients with partial CD56＋CD16＋ NK cells percentage, induction of immune tolerance, and then improve the receptivity of endometrium, promote embryo.
出处
《中国继续医学教育》
2015年第27期99-100,共2页
China Continuing Medical Education
