宫腔灌注粒细胞刺激因子对反复种植失败患者妊娠结局及免疫状态的影响

Effect of intrauterine perfusion of granulocyte stimulating factor on the pregnancy outcomes and immune state in patients with recurrent implantation failure

目的探讨宫腔内灌注粒细胞刺激因子(granulocyte colony-stimulating factor,G-CSF)对反复种植失败(recurrent implantation failure,RIF)患者胚胎种植率、临床妊娠率及免疫状态的影响。方法将拟行冷冻胚胎移植的69例RIF患者随机分成对照组(n=34)及治疗组(n=35)。治疗组行G-CSF宫腔灌注治疗,对照组行强的松5 mg口服治疗。结果治疗组与对照组的一般情况(年龄、不孕年限、BMI、血清卵泡刺激激素、雌二醇、黄体生成素及既往移植周期数)比较差异无统计学意义(P>0.05);治疗组的胚胎种植率(25.5%)、临床妊娠率(51.4%)及活产率(51.4%)均显著高于对照组(12.6%、26.5%和23.5%,P <0.05),且治疗后宫腔液中的INF-γ、IL-17较治疗前下降,而IL-10、TGF-β1及VEGF较治疗前显著上升(P <0.05)。结论宫腔灌注G-CSF可提高RIF患者胚胎种植率、临床妊娠率,改善RIF患者免疫状态。

Objective To investigate the effect of intrauterine infusion of granulocyte colony⁃stimulating factor(G⁃CSF)on clinical outcomes and immune statein patients with recurrent implantation failure(RIF).Methods A total of 69 RIF patients were divided randomly into control group(n=34)and treatment group(n=35).The treatment group received G⁃CSF intrauterine infusion,while the controls received orally prednisone treatment(5 mg/d).Results No significant differences in age,infertility duration,BMI,serum follicle stimulating hormone,luteinizing hormone,estradiol,and transplantation cycles were found between two groups(P>0.05).The embryo implantation rate(25.5%),clinical pregnancy rate(51.4%),and live birth rate(51.4%)in the treatment group⁃were all significantly higher than those in control group(12.6%,26.5%and 23.5%)(P<0.05).After G⁃CSF treatment,the levels of INF⁃γand IL⁃17 decreased significantly while the levels of IL⁃10,TGF⁃β1 and VEGF significantly increased(P<0.05).Conclusion The clinical outcomes and immune state of RIF patients could be improved by G⁃CSF intrauterine infusion.