自体外周血单个核细胞宫腔灌注对反复种植失败患者妊娠结局的影响  

Effect of intrauterine perfusion of autologous peripheral blood mononuclear cells of women with repeated implantation failure in IVF-ET on their pregnancy outcomes

作　　者：雷利娜[1] 张镛镛[1] 路莉娟 LEI Lina;ZHANG Yongyong;LU Lijuan(The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan Province, 471000)

机构地区：[1]河南科技大学第一附属医院,洛阳471000

出　　处：《中国计划生育学杂志》2021年第2期251-254,共4页Chinese Journal of Family Planning

基　　金：河南省医学科技攻关计划项目(2018020289)。

摘　　要：目的:探讨自体外周血单个核细胞(PBMCs)宫腔灌注对反复种植失败(RIF)患者妊娠结局的影响。方法:选取本院生殖中心接诊的80例RIF不孕症患者,随机数字表法分为两组各40例,两组均行体外受精-胚胎移植(IVF-ET)助孕,观察组在胚胎移植前分离自体PBMCs并行宫腔灌注,对照组不进行PBMCs宫腔灌注。检测观察组宫腔灌注前后宫腔液细胞因子水平变化,比较两组子宫内膜细胞培养液中的白血病抑制因子(LIF)、整合素αvβ3水平及妊娠结局。结果:与宫腔灌注前相比,观察组宫腔灌注后宫颈管内分泌物中的白细胞介素-6(IL-6)水平明显升高(355.85±65.74 ng/L比94.80±16.69 ng/L),肿瘤坏死因子-α(TNF-α水平明显降低(14.29±1.78 ng/L比17.20±1.86 ng/L)(P<0.05)。两组D1、D3日培养液中LIF、整合素αvβ3水平无差异(P>0.05),观察组D5日的LIF及整合素αvβ3水平均明显提高且高于对照组(P<0.05)。观察组与对照组胚胎种植率(32.5%比12.5%)、临床妊娠率(52.5%比27.5%)有差异(P<0.05),流产率(5.0%比0)无差异(P>0.05)。结论:RIF不孕症患者在胚胎移植前行自体PBMCs宫腔灌注能有效改善子宫内膜容受性,调节机体Th1/Th2免疫平衡,提高胚胎种植率及妊娠成功率,从而改善妊娠结局。Objective:To investigate the effect of intrauterine infusion of autologous peripheral blood mononuclear cells(PBMCs)of the women with repeated implantation failure(RIF)during in vitro fertilization and embryo transfer(IVF-ET)on their pregnancy outcomes.Methods:80 infertility women with RIF were selected and were divided into two groups(40 cases in each group)by random number table method.The women in the two groups were treated by IVF-ET.The women in the study group had received autogenous PBMCs culture and intrauterine perfusion before embryo transfer,while the women in the control group had not received PBMCs intrauterine perfusion.The change of cytokines levels in intrauterine fluid of the women before and after PBMCs intrauterine perfusion in the study group was observed.The leukemia inhibitory factor(LIF)level,integrinαVβ3 level,and pregnancy outcomes of the women were compared between the two groups.Results:After intrauterine perfusion,the level of interleukin-6(IL-6)in the secreta of cervix uteri of the women in the study group after PBMCs intrauterine perfusion was significant higher than that of the women in the control group(355.85±65.74ng/L vs.94.80±16.69ng/L),but the level of TNF-αin the secreta of cervix uteri of the women in the study group was significant lower than that of the women in the control group(14.29±1.78ng/L vs.17.20±1.86ng/L)(P<0.05).There were no significant different in the levels of LIF and integrinαVβ3 in culture medium of embryo on D1 and D3 of women between the two groups(P>0.05),but the levels of LIF and integrinαVβ3 in culture medium of embryo on D5 of women in both groups had significantly increased,and which of women in the study group were significant higher than those of women in the control group(P<0.05).There were significant differences in embryo implantation rate(32.5%vs.12.5%)and clinical pregnancy rate(52.5%vs.27.5%)of women between the two groups(P<0.05),but the abortion rate(5.0%vs.0%)of women had no significant different between the two groups(P>0.05).Con

关 键 词：体外受精-胚胎移植 反复种植失败 宫腔灌注 外周血单个核细胞 子宫内膜容受性 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]