孕激素诱导封闭因子在先兆流产中的作用

The function of PIBF in Threatened Abortion

目的通过研究先兆流产患者用孕激素治疗前后体内孕激素诱导封闭因子、孕激素、白介素2及白介素10在静脉血中的表达情况,了解PIBF对妊娠时Th1/Th2平衡的影响,探讨PIBF在先兆流产中的作用机制。方法选取遵义医学院第三附属医院2016年5月至2017年5月门诊收治的40例先兆流产患者作为研究组,选取同孕期门诊就诊的正常妊娠孕妇为对照组。研究组又分为黄体酮组和地屈孕酮组,黄体酮组20例给予黄体酮治疗,地屈孕酮组20例给予地屈孕酮治疗。对照组包含40例相同孕期的正常妊娠状态的妇女。应用酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)检测研究组及对照组治疗前后静脉血中的P、PIBF、IL-2及IL-10的表达情况。结果 (1)研究组治疗后血清P、PIBF、IL-10较治疗前明显升高,IL-2较前明显降低,差异均有显著性(P<0.05)。(2)研究组PIBF和IL-2呈负相关(r=0.421,P<0.05),和IL-10呈正相关(r=0.439,P<0.05)。(3)研究组不同孕激素治疗对PIBF的影响差异明显(P<0.05),地屈孕酮对PIBF的调控效果强于黄体酮。结论 (1)PIBF表达水平下调可影响Th1/Th2平衡状态向Th1细胞因子方向偏移,在孕激素保胎处理后,PIBF水平上调显著,Thl/Th2平衡状态向Th2细胞因子偏移明显,表明孕激素可以有效减少先兆流产的可能性。(2)孕酮通过影响孕妇体内PIBF的水平,保护胚胎,在一定程度上减免先兆流产的可能。孕早期孕妇体内PIBF水平的检测可用于评估孕激素的治疗效果和先兆流产的风险判断。

Objective terleukin -2 （IL - 2） and interleukin -10 （I L -10） in venous blood of patients with threatened abortion before and after treatment by progesterone, To investigate the effect of PIBF on Th 1/Th2 balance in normal pregnan-cy and to study the mechanism of PIBF in threatened abortion. Methods The study group was divided into study group and control group. The study group consisted of 40 patients with threatened abortion who were di-vided into progesterone group and dydrogesterone group. The dydrogesterone group was treated with dydroges- terone in 20 cases, The progesterone group was treated with progesterone in 20 cases. The control group includ-ed 40 women with the same pregnancy status during normal pregnancy. The expression of P , PIBF, IL - 2 and IL -10 in the venous blood of the study group and the control group were detected by enzyme - linked im-munosorbent assay （ELISA）. To analyze the correlation between the expression levels of PIBF, IL - 2 and IL - 10, and the difference was statistically analyzed. Results （1） In the study group before treatment, serum P、 PIBF ^IL ~ 10 was higher than that in the study group before treatment , IL - 2 was lower than that in the study group before treatment. The difference was statistically significant （P 〈 0 . 05）. （2）The study group was negatively correlated with PIBF and IL - 2（ r = 0.421, P〈C 0.05）, and IL - 10 was positively correlated（ r = 0. 439,P 〈0.05）. （3）There was a significant difference between the two groups （ P 〉0.05）. The effect of dydro-gesterone on PIBF was stronger than that of progesterone. Conclusions （1）Downregulation of PIBF expression may affect the Thl / Th2 equilibrium state to the Thl cytokine shift. The level of PIBF was up - regulated sig-nificantly in patients with threatened abortion after appropriate progesterone maternal treatment, T h l/Th2 bal-ance state to Th2 cytokine shift significantly, indicating that progesterone can effectively reduce the possibility of threatened abortion. （2）Through impact the level of PIBF of pregnant women, Progesterone can protect the em-bryo, to some extent, the possibility of reduction of threatened abortion. Detection of PIBF levels in pregnant women during early pregnancy can be used to assess the therapeutic effect of progesterone and the risk of threat-ened abortion.