淋巴细胞主动免疫治疗在反复胚胎种植失败患者中的应用研究

Application of active lymphocyte immunotherapy in patients with recurrent implantation failure

目的分析淋巴细胞主动免疫(LIT)治疗在反复胚胎种植失败(RIF)患者中的应用效果,以及对血清半乳糖凝集素(galectin)-3、galectin-1、宫颈分泌物肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的影响。方法选取2018年1月至2019年3月湖北省天门市第一人民医院收治的体外受精-胚胎移植(IVF-ET)患者144例作为研究对象,其中,RIF患者(RIF组)66例,非RIF患者(非RIF组)78例。首先比较两组患者血清galectin-3、galectin-1、宫颈分泌物TNF-α、IL-6差异,随后,利用LIT治疗RIF患者,观察治疗效果,并比较治疗前后上述指标的差异。结果RIF患者血清galectin-1、galectin-3、宫颈分泌物IL-6水平低于非RIF患者[排卵日:(35.94±3.91)μg/L比(39.26±3.75)μg/L、(53.10±5.91)μg/L比(57.68±6.87)μg/L、(73.13±16.69)μg/L比(90.98±16.25)μg/L;排卵后6 d:(43.13±4.53)μg/L比(48.95±6.23)μg/L、(68.61±7.70)μg/L比(72.25±7.94)μg/L、(81.11±16.02)μg/L比(91.21±18.13)μg/L],宫颈分泌物TNF-α水平高于非RIF患者[排卵日:(13.33±1.76)μg/L比(10.20±1.74)μg/L;排卵后6 d:(12.17±1.64)μg/L比(9.36±1.84)μg/L],差异有统计学意义(P<0.05);RIF患者经过LIT治疗后,胚胎种植率为25.45%(42/165),临床妊娠率为48.48%(32/66),流产率为9.38%(3/32);RIF患者经过LIT治疗后,血清galectin-1、galectin-3、宫颈分泌物IL-6水平高于治疗前,宫颈分泌物TNF-α水平低于治疗前,差异有统计学意义(P<0.05)。结论RIF患者血清galectin-1、galectin-3、宫颈分泌物TNF-α、IL-6水平与非RIF患者间存在一定的差异,LIT治疗可对上述指标产生影响,并对RIF患者具有一定的治疗作用。

Objective To analyze the effect of active lymphocyte immunotherapy(LIT)in patients with recurrent implantation failure(RIF),as well as its influence on serum galectin-3,galectin-1,tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in cervical secretions.Methods From January 2018 to March 2019,144 patients with in-vitro fertilization and embryo transfer(IVF-ET)admitted to the First People′s Hospital of Tianmen were enrolled.Among them,there were 66 patients with RIF(RIF group)and 78 cases without RIF(non-RIF group).First,the differences of serum galectin-3,galectin-1,TNF-αand IL-6 in cervical secretions were compared between the two groups.Subsequently,the patients with RIF were treated with LIT,and the therapeutic effects were observed.The differences of the above indicators before and after treatment were compared.Results The levels of serum galectin-1,galectin-3 and cervical secretion IL-6 in patients with RIF were lower than those in non-RIF patients[ovulation day:(35.94±3.91)μg/L vs.(39.26±3.75)μg/L,(53.10±5.91)μg/L vs.(57.68±6.87)μg/L,(73.13±16.69)μg/L vs.(90.98±16.25)μg/L;after ovulation for 6 d:(43.13±4.53)μg/L vs.(48.95±6.23)μg/L,(68.61±7.70)μg/L vs.(72.25±7.94)μg/L,(81.11±16.02)μg/L vs.(91.21±18.13)μg/L],the level of TNF-αin cervical secretion was higher than that in non-RIF patients[ovulation day:(13.33±1.76)μg/L vs.(10.20±1.74)μg/L;after ovulation for 6 d:(12.17±1.64)μg/L vs.(9.36±1.84)μg/L],and the differences were statistically significant(P<0.05).After LIT treatment,the embryo implantation rate was 25.45%(42/165),the clinical pregnancy rate was 48.48%(32/66),and the abortion rate was 9.38%(3/32).After treatment,the serum galectin-1,galectin-3,cervical secretion IL-6 levels were higher than those before treatment,cervical secretions TNF-αlevels were lower than before treatment,and the differences were statistically significant(P<0.05).Conclusions The levels of serum galectin-1,galectin-3,cervical secretions TNF-α,IL-6 in patients with RIF are different from those in non-RIF patients.LIT treatment can reduce the difference of these indicators and has certain treatment effect for patients with RIF.