反复种植失败患者行宫腔灌注PBMCs治疗的妊娠结局及血清TNF-α水平变化

Pregnancy outcomes and serum TNF-α levels in patients with repeated implantation failure treated with intrauterine perfusion of PBMCs

目的探讨反复种植失败(RIF)患者在冻融胚胎移植(F-ET)前行宫腔灌注自体外周血单个核细胞(PBMCs)治疗的妊娠结局。方法研究纳入60例RIF患者,随机分为宫腔灌注组和对照组各30例,宫腔灌注组于行黄体酮注射日当天抽取自体外周血制备新鲜自体PBMCs行宫腔灌注治疗,两组患者均行冻胚移植,移植后均进行常规黄体支持,随访其妊娠结局,并收集其治疗前、后外周血清,采用酶联免疫吸附测定法(ELISA)测定其中肿瘤坏死因子(TNF-α)水平。结果宫腔灌注组妊娠率(46.67%)显著高于对照组(36.67%),宫腔灌注治疗前后血清TNF-α水平变化无统计学差异。结论宫腔灌注自体PBMCs可以提高RIF患者冻胚移植的临床妊娠率,是临床上治疗RIF的一种新方式;宫腔灌注PBMCs治疗对外周血清TNF-α水平无影响。

Objective To explore the pregnancy outcomes of intrauterine perfusion of autologous peripheral blood mononuclear cells(PBMCs) in patients with repeated implantation failure(RIF) before fozen embryo transfer(F-ET).Methods Sixty RIF patients were included in this study and randomly divided into intrauterine perfusion group and control group with 30 cases in each group.Intrauterine perfusion group received fresh PBMCs from autologous peripheral blood on the day of progesterone injection and received intrauterine perfusion treatment.Frozen embryo transplantation was performed in both groups,and routine luteal support was performed after transplantation.The pregnancy outcomes were followed up,and peripheral blood serum before and after treatment was collected.The levels of TNF-α were determined by ELISA.Results Pregnancy rate of intrauterine perfusion group(46.67%) was significantly higher than that of control group(36.67%);There was no significant difference in serum TNF-α level before and after intrauterine perfusion.Conclusion Intrauterine perfusion of autologous PBMCs can improve the clinical pregnancy rate of frozen embryo transplantation in RIF patients,which is a new clinical method to treat RIF;Intrauterine perfusion of PBMCs had no effect on peripheral serum TNF-α level.