地屈孕酮片联合绒毛膜促性素治疗原因不明复发性流产及对T淋巴细胞和炎症因子影响

Clinical efficacy of ditroxyprogesterone tablets combined with choriotropin for treating women with unexplained recurrent abortion and its influence on their T lymphocyte cell and inflammatory factor levels

目的:探析地屈孕酮片联合绒毛膜促性素治疗原因不明复发性流产(URSA)疗效及对患者T淋巴细胞因子和炎症因子影响。方法:收集本院2017年6月—2018年11月收治的URSA患者100例,简单法随机分组,观察组50例采取地屈孕酮片联合绒毛膜促性素治疗,对照组50例采取黄体酮联合绒毛膜促性素治疗。对比两组妊娠8、12周血清白介素(IL)-4、IL-6、IL-10、IL-17、γ干扰素(INF-γ)、肿瘤坏死因子(TNF)-α,高敏C-反应蛋白(hs-CRP),CD4+调节性T细胞Treg(Treg/CD4+)、CD4+T辅助细胞Th17(Th17/CD4+)、辅助性T细胞17/调节性T细胞(Th17/Treg)。统计妊娠结局。结果:与妊娠8周比较,两组妊娠12周时IL-4、IL-10、Treg/CD4+均升高,IL-6、IL-17、INF-γ、TNF-α、hs-CRP、Th17/CD4+、Th17/Treg均降低(P<0.05),且观察组变化幅度高于对照组(均P<0.05)。观察组流产率(17.0%)低于对照组(40.9%),足月分娩率(63.8%)高于对照组(31.8%)(P<0.05)。结论:地屈孕酮片联合绒毛膜促性素治疗URSA效果良好,可调节患者T淋巴细胞因子及炎症因子水平,促进“母—胎”免疫平衡,降低流产风险,提高保胎成功率。

Objective:To explore the clinical efficacy of ditroxyprogesterone tablets combined with choriotropin for treating women with unexplained recurrent abortion(URSA),and to study its influence on T lymphocyte cell and inflammatory factor levels of women.Methods:100 women with URSA were enrolled in this study and divided into group A and Group B(50 cases in each group)according to simple randomized method from June 2017 to November 2018.The women in group A were treated with ditroxyprogesterone tablets combined with chorionic gonadotropin,and the women in Group B were treated with luteinone combined with chorionic gonadotropin.The serum levels of(IL)-4,IL-6,IL-10,IL-17,INF-γ,TNF-α,highly sensitive C-reactive protein(hs-CRP),CD4 regulatory T cell Treg(Treg/CD4),CD4 T helper cell Th17(Th17/CD4),helper T cell 17/regulatory T cell(Th17/Treg)of women during 8 and 12 gestational weeks were compared between the two groups.The pregnancy outcomes of women in the two groups were counted.Results:The levels of IL-4,IL-10,Treg CD4 of women in both groups during 12 gestational weeks were significant higher than those of women during 8 gestational weeks,but the levels of IL-6,IL-17,INF-γ,TNF-α,hs-CRP,Th17/CD4,and Th17/Treg of women in the two groups during 12 gestational weeks were significant lower than those of women during 8 gestational weeks,and the change degree of those of women in group A was significant more than those of women in group B(P<0.05).The rate of abortion of women in group A was 17.0%,which was significant lower than that(40.9%)of women in group B,and the rate of full term delivery of women in group A 63.8%,which was significant lower than that(31.8%)of women in group B(P<0.05).Conclusion:The combination of ditroxyprogesterone tablets and choriotropin for treating women with URSA is effective,which can regulate the level of T lymphocyte factor and inflammatory factor,can reduce the risk of abortion,and can mprove the success rate of pregnancy preservation by promoting the balance of mother-fetus immunity.