原因不明复发性流产患者免疫治疗前后血清中趋化因子水平变化

LEVELS OF SERUM CHEMOKINES BEFORE AND AFTER INITIATIVE IMMUNOTHERAPY IN UNEXPLAINED RECURRENT SPONTANEOUS ABORTION WOMEN

目的研究主动免疫治疗前后血清中单核细胞趋化蛋白1(monocyte chemotactic protein-1,MCP-1)、正常T细胞活化后所表达和分泌的调节蛋白(regulated upon activation nomal T cell expressed and secreted,RANTES)和白细胞介素8(interlukin-8,IL-8)水平变化,探讨其在原因不明复发性流产(unexplained recurrent spontaneousabortion,URSA)发病中的作用。方法 2011年4月—2012年5月在河北医科大学第二医院生殖医学科就诊的URSA患者40例为研究组,正常非孕及正常妊娠组各20例为对照组。采用酶联免疫吸附法检测免疫治疗前后血清中MCP-1、RANTES、IL-8水平。结果 URSA患者治疗前血清中MCP-1、RANTES、IL-8水平均明显低于正常非孕组与正常妊娠组,差异有统计学意义(P<0.05),而正常非孕组与正常妊娠组之间差异无统计学意义(P>0.05)。URSA患者免疫治疗后血清中MCP-1、RANTES、IL-8水平明显上升,与免疫治疗前相比差异有统计学意义(P<0.05)。40例URSA患者根据免疫治疗后是否持续妊娠分为持续妊娠组27例和非持续妊娠组13例。持续妊娠组免疫治疗后血清中MCP-1、RANTES、IL-8水平增长率明显高于非持续妊娠组,差异有统计学意义(P<0.05)。结论主动免疫治疗可提高URSA患者血清中MCP-1、RANTES、IL-8水平,在持续妊娠组升高明显,尤其是RANTES具有封闭抗体效应,更有利于妊娠的持续发展。

Objective The serum levels of three chemokines monocyte chemotactic protein-1 （MCP-1） ,regulated upon activation nomal T cell expressed and secreted （RANTES）, intedeukin-8 （IL- 8 ） before and after active immunotherapy were studied for the effect in the unexplained recurrent spontaneous abortion （URSA） pathogenesis. Methods Forty URSA patients in the hospital from April 2011 to May 2012 were enrolled in study group, with 20 normal non-pregnant,20 normal pregnancy women were included in control groups. The levels of MCP-1, RANTES and IL-8 were determined using enzyme linked immunosorbent assay. Results The levels of MCP-1, RANTES, IL-8 of URSA patients before treatment were significantly lower than those of normal non-pregnant group and normal pregnancy group,the differences were statistically significant （ all P 〈 0.05 ）, while the differences between the normal non-pregnant group and the normal pregnancy group had no statistical significance （P 〉 0.05 ）.The levels of MCP-I, RANTES, IL-8 in serum were significantly increased in URSA patients after immune treatment compared with before treatment, the differences were statistically significant （ P 〈 0.05 ）. According to whether to continue pregnancy after immunotherapy,40 cases of URSA patients were divided into the ongoing pregnancy group with 27 cases, and the non ongoing pregnant group with 13 cases. The growth rates of MCP-1, RANTES, IL-8 levels after treatment in the ongoing pregnancy group were higher than those of the non ongoing pregnant group, the differences were statistically significant （ P 〈 0.05 ）. Conclusion The levels of MCP-1, RANTES, IL-8 in patients with URSA can be improved after active immunotherapy, especially in the ongoing pregnancy group. RANTES with a blocking antibody effect, may be more conducive to the sustainable development of pregnancy.