生殖道局部细胞免疫与黄体功能不全患者不孕的关系

Study the relationship between the immune of reproductive tract and corpus luteum local cell insufficiency for patients of infertility

目的:探讨生殖道局部细胞免疫与黄体功能不全患者不孕的关系。方法:研究纳入21例确诊为黄体功能不全(luteal phase deficiency,LPD)的患者作为研究组,同时纳入18例健康体检者最为对照组,使用放射免疫法(radiation immunity analysis,RIA)对排卵期两组血清、宫颈黏液中白细胞介素1-β(IL-1β)以及肿瘤坏死因子-α(TNF-α)的表达进行检测;使用化学发光免疫分析仪检测两组黄体期的血清孕酮水平。结果:黄体期,研究组血清孕酮水平明显高于对照组,差异有统计学意义(P<0.05);排卵期,研究组宫颈黏液中IL-1β以及TNF-α水平与对照组比较,差异有统计学意义(P<0.05);研究组宫颈黏液中IL-1β以及TNF-α水平与黄体中期血清孕酮水平存在负相关(r=-0.888,P<0.05;r=-0.849,P<0.05);宫颈黏液中IL-1β水平与TNF-α水平存在正相关(r=0.797,P<0.05)。结论:排卵期生殖道局部细胞免疫受到激活,可能是LPD患者发生不孕的主要免疫因素之一,亦能够间接的影响黄体发育从而造成LPD的发生。

Objective： To investigate the relationship between the immune of reproductive tract and corpus luteum local cell insufficiency for patients of infertility. Methods： The study included 21cases of patients diagnosed with luteal insufficiency （Luteal phase deficiency, LPD） as study group, and 18 cases of healthy people were as the control group, using radioimmuno- assay （Radiation immunity analysis, RIA） on interleukin two in serum, ovulation in cervical mucus beta （IL-1） and tumor necrosis factor alpha （TNF-alpha） were detected by using expression~ chemiluminescence immunoassay analyzer were used for detection of two groups of luteal phase serum progesterone levels. Results： The level of serum progesterone in luteal phase, study group was significantly higher than the control group, the difference was significant （P〈0.05）; the ovulation period, research group IL-1 beta and alpha level of serum TNF- were （0. 153±0. 053） g/L, （0. 562±0. 178） g/L, the control group （0. 141±0. 045） u g/L, （0. 656±0.184） g/L, there was no significant difference （P〉0.05）, the ovulation period, research group IL-1 beta and alpha in cervical mucus TNF- levels were （1. 545±0. 542） and （2. 451±0. 685）, control group （1. 257±0. 274） and （1. 897±0. 464）, differences there was significant （P〈0.05）; there is a negative correlation of serum progesterone level in cervical mucus interim study group IL-1 beta and TNF- alpha level and corpus luteum （r=-0. 888, P〈0.05; r= -0. 849,P〈0.05）; there is a positive correlation of cervical mucus IL-1 levels and TNF- levels （r=0. 797, P〈0.05）. Conclusion： The local cellular immune in reproductive tract of ovulation activated may be one of the main factors for LPD patients with infertility, also can indirectly influence the development of corpus luteum, which can produce LPD.