米非司酮对胚胎生长及TGF-β和TNF-α水平的影响分析

Study on effect of mifepristone on embryonic growth and expression of TGF-β and TNF-α

目的探讨米非司酮对胚胎生长、早孕蜕膜和绒毛中转化生长因子β(TGF-β)以及血清肿瘤坏死因子α(TNF-α)的影响。方法临床纳入自愿进行人工流产的妊娠妇女90例,根据人工流产术前处理方案的不同分为研究组与对照组。研究组人工流产术前给予100 mg米非司酮口服,对照组不给于米非司酮口服。使用反转录-聚合酶链反应(RT-PCR)检测两组早孕蜕膜和绒毛中TGF-β1以及受体TGF-β1R基因的表达情况;使用放射免疫法检测研究组服药前后血清TNF-α的水平。结果研究组蜕膜中TGF-β1以及受体TGF-β1R基因表达明显高于对照组(1.66±0.61 vs.1.00±0.46;1.54±0.50 vs.0.89±0.30),差异均有显著性(P<0.05);两组绒毛中TGF-β1以及受体TGF-β1R基因表达未见明显差异(P>0.05)。研究组服用米非司酮后血清TNF-α明显高于服药前(0.87±0.14μg/L vs.0.55±0.10μg/L),差异有显著性(P<0.05)。结论米非司酮能够明显组阻止胚胎的生长、发育,其能够通过下调蜕膜中TGF-β1以及受体TGF-β1R的转录,提升血清TNF-α的水平,从母-胎界面局部至外周,促使免疫刺激以及抑制失调,造成母体对胚胎排斥而不利于妊娠的维持。

Objective To explore the effect of mifepristone on embryonic growth and transforming growth factor β（ TGF- β） in decidua and villi,and serum tumor necrosis factor α（ TNF- α）. Methods Ninety pregnant women with voluntary artificial abortion were divided into study group and control group according to the difference in induced abortion before treatment scheme. Pregnant women in study group were administrated with 100 mg mifepristone before induced abortion,and pregnant women in control group had not received mifepristone. The expression of TGF- β1 and TGF- β1 R in decidus and villus of 2 groups was examined by reverse transcription polymerase chain reaction,and serum level of TNF- α was examined by radioimmunoassay. Results The gene expressions of TGF- β1 in decidua and TGF- β1R in study group were 1. 66 ±0. 61 and 1. 54 ± 0. 50 respectively,and they were 1 ± 0. 46 and 0. 89 ± 0. 30 respectively in control group,and the difference was significant（ P〈0. 05）; the difference in expression of TGF- β1 and TGF- β1R in villi between these two groups was not significant（ P〉0. 05）. The serum level of TNF- α in study group before taking mifepristone was 0. 55 ± 0. 10 μg / L,and serum level of TNF- αafter taking the drug was 0. 87 ± 0.14 μg / L,and. their difference was significant（ P〈0. 05）. Conclusion Mifepristone can obviously prevent the growth of embryo,it can raise the serum level of TNF- αthrough down- regulation of decidual TGF- β1 and TGF- β1 R transcription,prompting the immune stimulation and inhibition of disorders from maternal and fetal interface from local to peripheral,resulting in the body of mother and not conductive to the maintenance of fetal rejection of pregnancy.