摘要
目的观察羟氯喹调节反复种植失败患者母胎界面免疫耐受失衡的临床疗效及相关影响因素水平变化。方法选取2021年10月至2022年10月在我院生殖医学科助孕治疗的RIF患者102例,随机分为试验组和对照组各51例。对照组给予激素替代周期内膜准备,转化内膜后行卵裂期胚胎移植,移植后予药物黄体支持治疗,试验组在对照组基础助孕治疗上加用HCQ免疫调节治疗,对比分析两组患者临床妊娠结局及相关影响因素水平变化。结果试验组患者胚胎着床率高于对照组(P<0.05)。治疗后,试验组D-2聚体、子宫动脉阻力RI明显低于对照组(P<0.05)。治疗后,试验组血清IL-2、INF-γ、TNF-α水平均低于对照组,IL-4、IL-6、IL-10水平均高于对照组(P<0.01)。治疗后,试验组患者血清,NK(CD3^(-)CD16^(+)CD56^(+))水平、TH/TS比值均低于对照组(P<0.01)。结论HCQ可有效改善RIF患者母胎界面免疫耐受微环境,提高临床妊娠率。
Objectives To observe the clinical efficacy of hydroxychloroquine(HCQ)in regulating the imbalance of maternal-fetal interface immune tolerance in patients with repeated implantation failure(RIF)and the changes of related influencing factors.Methods A total of 102 RIF patients who received pregnancy-assisted therapy in the Department of Reproductive Medicine from October 2021 to October 2022 were selected and randomly divided into experimental group and control group,with 51 cases in each group.The control group was given hormone replacement cycle endometrial preparation,cleavage stage embryo transfer after endometrial transformation,and drug luteal support treatment after transplantation.The experimental group was treated with HCQ immunomodulatory therapy on the basis of the control group.Results The embryo implantation rateof the experimental group was significantly higher than that of the control group(P<0.05).After treatment,D-2 polymer and uterine artery resistance RI in the experimental group were significantly lower than those in the control group(P<0.05).After treatment,the levels of IL-2,INF-γand TNF-αin the experimental group were significantly lower than those of control group,and the levels of IL-4,IL-6 and IL-10 in experimental group were significantly higher than those of control group(P<0.01).After treatment,the levels of serum NK(CD3^(-)CD16^(+)CD56^(+)) and TH/TS ratio in experimental group were significantly lower than those in control group(P<0.01).Conclusions HCQ can effectively improve the immune tolerance microenvironment of maternal-fetal interface of RIF patients and improve the clinical pregnancy rate.
作者
蓝婧
李琳
蒋婉雪
LAN Jing;LI Lin;JIANG Wanxue(Nanchang Reproductive Hospital;Jiangxi University of Traditional Chinese Medicine,Nanchang Jiangxi 330104,China)
出处
《现代诊断与治疗》
CAS
2023年第15期2213-2216,共4页
Modern Diagnosis and Treatment
基金
江西省卫生健康委科技计划(项目编号202211688)。
关键词
羟氯喹
母胎界面免疫耐受
反复种植失败
Hydroxychloroquine
Maternal fetal interface immune tolerance
Recurrent implantation failure
