反复种植失败患者外周血NK细胞的临床意义

Clinical significance of peripheral blood NK cells in patients with repeated implantation failure

目的探讨外周血自然杀伤(natural killer,NK)细胞比例差异与反复种植失败(repeated implantation failure,RIF)的关联性,外周血NK细胞比例对RIF患者胚胎移植后妊娠结局的预测价值。方法选取2016年6月至2018年6月在桂林医学院附属医院生殖医学中心行体外受精胚胎移植( in vitro fertilization and embryo transplantation,IVF-ET)的RIF患者(77例)与非RIF患者(59例),用流式细胞仪检测两组患者月经期外周血CD3 -CD16 +CD56 +(NK)细胞群占淋巴细胞的比例。本研究通过回顾性分析,根据妊娠结局再将RIF患者分为妊娠失败组(49例)和妊娠组(28例),比较RIF患者妊娠失败组与妊娠组间月经期及胚胎种植日NK细胞比例差异。结果月经期RIF组较非RIF组患者外周血NK细胞比例增高,差异有统计学意义[(20.78±7.64)% vs (16.37±6.59)%, P <0.05];RIF 患者妊娠失败组与妊娠组月经期、胚胎移植日NK细胞比例相比较无明显差异[(21.16±8.15)% vs (20.37±8.48)%,(19.69±8.15)% vs (19.03±4.36)%, P >0.05]。结论 RIF的发生与月经期外周血NK细胞比例的异常增高具有一定的相关性,然而月经期及胚胎移植日NK比例水平对RIF患者胚胎种植结局无明显预测价值。

Objective To explore the correlation between the natural killer (NK) cell ratio in peripheral blood and repeated implantation failure (RIF),and the predict value of the NK cell ratio for pregnancy outcome of patients with RIF. Methods The RIF patients ( n =77) and non-RIF patients ( n =59) visited our fertility center from Jun,2016 to Jun,2018 for in vitro fertilization and embryo transplantation (IVF-ET) were enrolled in this study.The proportion of CD3 -CD16 +CD56 +(NK) cells in peripheral blood of the two groups was determined by flow cytometry in menstrual period.According to pregnancy outcomes,the patients were divided into implantation failure group and implantation success group for the RIF group,to compare the differences of the NK cell proportions among the groups before implantation. Results The NK cells ratio in peripheral blood of RIF group was higher than that of non-RIF group during menstruation period,and the difference was statistically significant[(20.78±7.64)% vs (16.37±6.59)%, P <0.05].There was no significant difference in the proportion of NK cells between the pregnancy failure group and the pregnancy group in menstrual period and embryo transfer day for patients with RIF[(21.16±8.15)% vs (20.37±8.48)%,(19.69±8.15)% vs (19.03±4.36)%, P >0.05 ]. Conclusions Association was found between the abnormal increase of the NK cell proportion in the peripheral blood and RIF during menstruation.No significant association was found between the NK cell ratios and implantation failure in menstrual period and embryo transfer day for the patients with RIF.NK cell ratio levelin menstrual period and embryo transfer day had no predict value for the pregnancy outcome of patients with RIF.