不明原因复发性流产患者分泌晚期外周血中自噬水平对蜕膜化调控作用及补肾活血方干预机制  

Regulation of Autophagy Level in Peripheral Blood of Patients with Unexplained Recurrent Abortion on Decidualization in Late Secretory Phase and Intervention Mechanism of Bushen Huoxue Recipe(补肾活血方)

作　　者：冯晓玲[1] 任佳杰 赵小萱 郗红燕 郭鲁秦 FENG Xiaoling;REN Jiajie;ZHAO Xiaoxuan;XI Hongyan;GUO Luqin(The First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China;Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)

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

出　　处：《中华中医药学刊》2023年第2期1-4,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82174421,81973894);黑龙江中医药大学研究生创新科研项目(2020yjscx003)。

摘　　要：目的探索分泌晚期外周血中自噬水平的异常对不明原因复发性流产(unexplained recurrent spontaneous abortion,URSA)患者蜕膜化的影响及补肾活血方的作用机制。方法收集至少有过一次成功妊娠且无自然流产史的女性(对照组)40例和肾虚血瘀型URSA患者(观察组)40例。观察组在入组后的3个月内严格按照实验要求服用中药汤剂补肾活血方。运用ELISA法检测两组分泌晚期血清中人胰岛素样生长因子结合蛋白1(insulin-like growth factor-binding protein-1,IGFBP-1)和催乳素(prolactin,PRL)水平,Western blot法检测微管相关蛋白1轻链3(LC3)、自噬相关基因6(Beclin 1)、泛素样结合蛋白(p62)、雷帕霉素靶蛋白(mTOR)表达。结果(1)观察组中自噬水平、蜕膜化水平较对照组女性明显降低。(2)治疗后观察组自噬水平、蜕膜化水平较入组时有明显改善。结论(1)URSA患者分泌晚期外周血中自噬水平降低影响蜕膜化水平,进而增加流产发生的风险。(2)补肾活血方可显著改善肾虚血瘀型URSA患者分泌晚期外周血中自噬水平,进而改善蜕膜化状态,为正常妊娠奠定基础。Objective To explore the effect of abnormal levels of autophagy in peripheral blood at the late secretory stage on decidualization of patients with unexplained recurrent spontaneous abortion(URSA)and the mechanism of Bushen Huoxue Reci⁃pe(补肾活血方).Methods Forty healthy women with at least one successful pregnancy and no history of spontaneous abortion were collected as the control group and 40 cases of URSA patients with kidney deficiency and blood stasis type were collected as the observation group.The observation group took Chinese medicine decoction Bushen Huoxue Recipe in strict accordance with the experimental requirements within 3 months after joining the group.The levels of human insulin-like growth factor binding protein-1(IGFBP-1)and prolactin(PRL)in late secretory serum of the two groups were detected by ELISA,and the expres⁃sions of microtubule associated protein 1 light chain 3(LC3),autophagy related gene 6(Beclin 1),ubiquitin like binding protein(p62)and rapamycin target protein(mTOR)were detected by Western blot.Results(1)The levels of autophagy and decidual⁃ization in the observation group were significantly lower than those in the control group.(2)After treatment,the level of autoph⁃agy and decidualization in the observation group were significantly improved compared to when they were enrolled in the group.Conclusions(1)Decreased level of autophagy in peripheral blood of patients with URSA affects the level of decidualization,thereby increasing the risk of miscarriage.(2)Bushen Huoxue Recipe can significantly improve the level of autophagy in the pe⁃ripheral blood of patients with kidney deficiency and blood stasis type in the late secretion period,thereby improving the state of decidualization and laying the foundation for normal pregnancy.

关 键 词：不明原因复发性流产 自噬 蜕膜化 补肾活血方 

分 类 号：R271.914.21[医药卫生—中西医结合]