补肾活血方对肾虚血瘀型URSA患者血清中胎盘外泌体PLAP及四跨膜蛋白CD9、CD63的影响  

Effects of Bushen Huoxue Formula on placental exosomal PLAP and transmembrane proteins CD9 and CD63 in serum of URSA patients with kidney deficiency and blood stasis

作　　者：冯晓玲[1] 曹雯雯 马薇薇[2] 赵小萱 刘子维 李娜[1] FENG Xiao-ling;CAO Wen-wen;MA Wei-wei;ZHAO Xiao-xuan;LIU Zi-wei;LI Na(The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院,哈尔滨150040 [2]黑龙江中医药大学,哈尔滨150040

出　　处：《中华中医药杂志》2023年第3期1361-1366,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81973894);黑龙江中医药大学科研资金项目(No.201827)。

摘　　要：目的:观察补肾活血方对肾虚血瘀型不明原因复发性流产(URSA)患者血清中胎盘外泌体碱性磷酸酶(PLAP)及四跨膜蛋白家族中CD9、CD63的影响,探讨其防治URSA的可能机制。方法:将80例早孕的URSA患者随机分为中药+西药组(补肾活血方+地屈孕酮片)、单纯西药组(单纯地屈孕酮片),每组40例,治疗4周,同时收集40例正常妊娠妇女,采用ELISA和Western Blot法测定用药前后血清PLAP及CD9、CD63表达水平,并与正常妊娠组比较。结果:入组时,两组URSA患者PLAP表达水平显著低于正常组(P<0.05),入组4周后中药+西药组、西药组两组PLAP表达水平均显著上调(P<0.05),中药+西药组表达水平显著高于西药组(P<0.05),且接近正常妊娠组;入组时,两组URSA患者CD9、CD63表达水平显著高于正常妊娠组(P<0.05),入组4周后中药+西药组、西药组两组CD9、CD63表达水平均显著下调(P<0.05),中药+西药组表达水平显著低于西药组(P<0.05),且接近正常妊娠组。结论:补肾活血方能够调节体内PLAP及CD9、CD63的水平,调整母胎界面的免疫平衡,增强子宫内膜容受性,改善不良妊娠结局。Objective:To observe the effects of Bushen Huoxue Formula on placental exosome alkaline phosphatase(PLAP)and transmembrane proteins CD9 and CD63 in the tetrapembrane protein family in serum of unexplained recurrentspontaneous abortion(URSA)patients with kidney deficiency and blood stasis,and to explore the possible mechanism of its prevention and treatment for URSA.Methods:Eighty URSA patients with early pregnancy were randomly divided into traditional Chinese medicine+Western medicine group(Bushen Huoxue Formula+dydrogestronetablets)and western medicine alone group(dydrogestrone tablets alone)and treated 4 weeks.Meanwhile,40 normal pregnant women were collected.ELISA and Western blot were used to determine the levels of CD9 and CD63 proteins and PLAP before and after treatment,and compared with the normal group.Results:At the time of enrollment,the PLAP expression level of URSA patients was significantly lower than that of the normal group(P<0.05).After 4 weeks of medication,the PLAP expression level in the Chinese medicine+Western medicine group and western medicine group were increased(P<0.05).The expression level of the Chinese medicine+Western medicine group was higher than that of the western medicine group(P<0.05),and was close to that of the normal pregnancy group.At the time of enrollment,the expression levels of CD9 and CD63 in URSA patients were significantly higher than those in normal pregnancy group(P<0.05).After 4 weeks of medication,the CD9 and CD63 expression level in Chinese medicine+Western medicine group and western medicine group were decreased(P<0.05),and the expression level of Chinese medicine+Western medicine group was lower than that of western medicine group(P<0.05),and closed to normal pregnancy group.Conclusion:Bushen Huoxue Formula can regulate the levels of placental exosomes PLAP and their transmembrane proteins CD9 and CD63,adjust the immune balance of maternal-fetal interface,enhance endometrial tolerance,and improve the adverse pregnancy outcome.

关 键 词：不明原因复发性流产 补肾活血方 胎盘外泌体 四跨膜蛋白 

分 类 号：R271.9[医药卫生—中西医结合]