摘要
目的探讨胚胎移植术后成功妊娠患者孕早期TH1/TH2细胞因子水平对妊娠结局的影响。方法选取2018年6月~2020年6月在我院行胚胎移植术后成功妊娠的920个周期,根据妊娠结局分为3组:妊娠组(B超提示见胚芽、胎心)648例、生化妊娠组(血HCG自然下降至未孕状态)114例、流产组(发生自然流产或胚胎停育)158例,比较三组患者的基本情况及胚胎移植术后15~17天(孕4~5周)TH1/TH2细胞因子水平。结果妊娠组和流产组的TH1型细胞因子IL2、TNF-α及TH2型细胞因子IL4、IL10与生化妊娠组相比有升高的趋势,但差异无统计学意义(P>0.05);妊娠组、生化妊娠组、流产组的TH1型细胞因子IFN-γ水平分别为2.26±1.48、1.89±0.93、2.28±1.08,其中生化妊娠组的IFN-γ水平显著低于妊娠组及流产组,差异有统计学意义(P<0.05);妊娠组、生化妊娠组、流产组TH2型细胞因子IL6水平分别为3.45±1.57、2.96±1.20、3.14±1.42,其中妊娠组IL6水平显著高于生化妊娠组及流产组,差异有统计学意义(P<0.05)。结论妊娠早期,TH1转移的轻度免疫炎症变化有利于胚胎的种植,其中TH1型细胞因子IFN-γ及TH2型IL6在胚胎早期种植过程中起到非常重要的作用,若出现失衡则会引起生化妊娠或流产的发生。
Objective To investigate the effect of TH1/TH2 cytokine level in early pregnancy after embryo transfer.Methods 920 cycles of successful pregnancyafter embryo transfer in our hospital from June 2018 to June 2020 were selected.The patients weredivided into 3 groups according to pregnancy outcomes,namely the normal pregnancy group(648 cases with embryo and fetal heart indicated by B ultrasound),the biochemical pregnancy group(114 cases with natural decrease of blood HCG to non-pregnancy level),and the abortion group(158 cases with spontaneous abortion or embryo development arrest).The basic condition and TH1/TH2 cytokine levels 15 to 17 days after embryo transfer(4 to 5 weeks of gestation)were compared among the three groups.Results The level of TH1 cytokines IL2,TNF-α,and TH2cytokinesIL4 and IL10 innormal pregnancy group and abortion group were higher than those of biochemical pregnancy group,yet the differences were not statistically significant(P>0.05).The levels of TH1 cytokineIFN-γin pregnancy group,biochemical pregnancy group and abortion group were respectively 2.26±1.48,1.89±0.93 and 2.28±1.08,among which the level of IFN-γin biochemical pregnancy group was significantly lower than that of pregnancy group and abortion group(P<0.05).The levels of TH2 cytokineIL6 in pregnancy group,biochemical pregnancy group and abortion group were respectively 3.45±1.57,2.96±1.20 and 3.14±1.42,among which the level of IL6 in pregnancy group was significantly higher than biochemical pregnancy group and abortion group(P<0.05).ConclusionIn Theearly pregnancy,mild immune inflammatory changes in TH1 metastasis are beneficial for embryo transfer.Especially,the TH1 cytokine IFN-γand TH2cytokine IL6 play an important role in the early embryo transfer process,while the imbalance of immunological function can probablylead to biochemical pregnancy or abortion.
作者
杨丽娟
李洁
李琳
刘居理
马玲
胥杜娟
YANG Li-juan;LI Jie;LI Lin;LIU Ju-li;MA Ling;XU Du-juan(Reproductive Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330000,China)
出处
《现代诊断与治疗》
CAS
2021年第20期3195-3198,共4页
Modern Diagnosis and Treatment
基金
江西省卫生计生委科技计划(合同编号:20197080)。
