葛根素、安宫黄体酮序贯治疗卵巢早衰患者的免疫指标观察  

Immune functions in premature ovarian failure patients undergoing sequential therapy of puerarin and medroxyprogesterone

作　　者：张金慧[1] 杜洪灵[1] 周琼青[1] Zhang Jinhui Du Hongling Zhou Qiongqing(Department of Obstetrics and Gynecology of Putuo District People＇s Hospital, Shanghai 200060, Chin)

机构地区：[1]上海市普陀区人民医院妇产科,200060

出　　处：《中华全科医师杂志》2016年第12期947-950,共4页Chinese Journal of General Practitioners

基　　金：2013年上海市普陀区科委卫生系统自主创新科研资助项目（普KW15201）

摘　　要：2012年1月1日到2014年12月，对40例抗卵巢抗体（ AoAb）阳性的卵巢早衰患者应用葛根素、安宫黄体酮序贯疗法治疗12个周期，葛根素片1片、1次／d，28 d为1周期，每周期的第1928天加服安宫黄体酮10 mg、1次／d，观察治疗前后血清AoAb、抗核抗体及淋巴细胞计数等指标的变化，用Kupperman评分法观察围绝经期症状况。治疗后Kupperman评分显著性降低[（48±18）比（21±14）分，P＜0.05]，其中14例（35％）治愈；抗核抗体阳性率[36例（90％）比18例（45％）]、AoAb转阴率[40例（100％）比14例（35％）]和抗体浓度显著性降低[（6.9±2.4）与（3.7±2.5）kU／L，P＜0.05]。 CD8＋T淋巴细胞数明显增加，CD3＋、CD4＋T淋巴细胞数、CD4＋／CD8＋T淋巴细胞值、CD19＋B淋巴细胞数明显降低（均P＜0.05）。 Kupperman评分变化与AoAb、CD3＋、CD4＋T淋巴细胞数、CD19＋B淋巴细胞数呈正相关（r值分别为0.717、0.412、0.673和0.637，均P＜0.05）；与ANA变化呈弱正相关（r＝0.391，P＜0.05）；与CD8＋T淋巴细胞数呈负相关（r＝－0.677，P＜0.05）。Forty premature ovarian failure（POF）patients with positive antiovary antibody （AoAb） underwent puerarin and progesterone sequential therapy from January 2012 to December 2014.Patients received 12 cycles of sequential therapy , each cycle consisted of puerarin 1 tablet q.d from d1 to d28 and medroxyprogesterone acetate 10 mg q.d from d19 to d28.Serum AoAb, antinuclear antibody （ ANA）, CD3 ＋, CD4 ＋and CD4 ＋/CD8 ＋, CD8 ＋T lymphocytes and CD19 ＋B lymphocytes were measured before and after treatment , perimenopausal period was evaluated with Kupperman score.Results showed that the Kupperman score after treatment was decreased from （48 ±18） to （21 ±14） （P 〈0.05）, and 14 cases were cured （35%）;the positive rates of ANA （from 90%to 45%） and AoAb （from 100%to 35%） were significantly decreased after treatment （ P 〈0.05 ） and the AoAb concentrations were also significantly decreased [ from （ 6.9 ±2.4 ） to （ 3.7 ±2.5 ） kU/L, P 〈0.05 ]; CD8 ＋ increased significantly （ P 〈0.05 ） , CD3 ＋, CD4 ＋T lymphocytes and CD 19 ＋B lymphocyte counts , and CD4 ＋/CD8 ＋ ratio were significantly decreased after treatment （all P〈0.05）.Kupperman score changes were positively correlated with changes of ANA and AoAb , CD3 ＋and CD4 ＋T lymphocytes （ r=0.391,0.717, 0.412, 0.673 and 0.637, all P〈0.05）;and negatively correlated with the number of CD 8＋T cells （ r=-0.657,P〈0.05）.

关 键 词：原发性卵巢功能不全 葛根素 抗体 

分 类 号：R711.75[医药卫生—妇产科学]