国际妇产科学杂志

国际妇产科学杂志 ›› 2023, Vol. 50 ›› Issue (5): 502-506.doi: 10.12280/gjfckx.20230414

• 产科生理及产科疾病:论著 • 上一篇    下一篇

复发性流产患者宫腔微环境对早期妊娠的影响

蔺凯丽, 郭洁, 张崴, 宋殿荣(), 张继雯, 怀其娟, 赵琳   

  1. 300150 天津中医药大学第二附属医院妇科
  • 收稿日期:2023-06-05 出版日期:2023-10-15 发布日期:2023-10-16
  • 通讯作者: 宋殿荣，E-mail：songdr58@126.com
  • 基金资助:
    天津市教委科研计划项目(2022KJ184);天津中医药大学第二附属医院2020年度青苗计划(QMJH202016)

Effect of Uterine Microenvironment on Early Pregnancy in Patients with Recurrent Spontaneous Abortion

LIN Kai-li, GUO Jie, ZHANG Wei, SONG Dian-rong(), ZHANG Ji-wen, HUAI Qi-juan, ZHAO Lin   

  1. Department of Gynecology, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300150, China
  • Received:2023-06-05 Published:2023-10-15 Online:2023-10-16
  • Contact: SONG Dian-rong, E-mail: songdr58@126.com

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摘要：

目的：初步探讨复发性流产（recurrent spontaneous abortion，RSA）患者宫腔微环境对早期妊娠的影响。方法：采集2021年10月—2022年1月就诊于我院拟行清宫术的RSA患者和同期拟行人工流产术的正常早孕女性的宫腔灌洗液，检测其脂多糖（lipopolysaccharide，LPS）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白细胞介素-2（interleukin-2，IL-2）、γ干扰素（interferon-γ，IFN-γ）浓度，并用宫腔灌洗液分别干预子宫内膜细胞和绒毛外滋养细胞，检测子宫内膜细胞TNF-α、IL-2、IFN-γ mRNA的表达，以及绒毛外滋养细胞的侵袭迁移能力。结果：RSA患者宫腔灌洗液中LPS、TNF-α、IL-2、IFN-γ的浓度均高于正常早孕女性，差异有统计学意义（均P<0.05）。RSA患者的宫腔灌洗液干预子宫内膜细胞后，TNF-α、IL-2、IFN-γ mRNA的表达均较正常早孕女性宫腔灌洗液干预组升高，差异有统计学意义（均P<0.05）。RSA患者宫腔灌洗液干预后的绒毛外滋养细胞的侵袭细胞数目、细胞迁移面积均较正常早孕女性宫腔灌洗液干预后的绒毛外滋养细胞降低，差异有统计学意义（均P<0.05）。结论：RSA患者宫腔呈现微炎症状态，影响绒毛外滋养细胞的侵袭迁移能力，不利于妊娠维持。

关键词: 流产, 习惯性, 妊娠, 细胞微环境, 细胞因子类, 宫腔灌洗液

Abstract:

Objective: To investigate the effect of uterine microenvironment on early pregnancy in patients with recurrent spontaneous abortion (RSA). Methods: From October 2021 to January 2022, intrauterine lavage was collected from RSA patients who were admitted to our hospital for uterine clear operation and normal early pregnant women who were admitted for induced abortion during the same period. Concentrations of lipopolysaccharide (LPS), tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2) and interferon-γ (IFN-γ) were detected. Endometrial cells and extravillous trophoblast cells were respectively interfered with intrauterine lavage to detect mRNA expression of TNF-α, IL-2, IFN-γ in endometrial cells and invasion and migration ability of extravillous trophoblast cells. Results: The concentrations of LPS, TNF-α, IL-2 and IFN-γ in intrauterine lavage of RSA patients were significantly higher than those of normal women in early pregnancy (P<0.05). The mRNA expressions of pro-inflammatory factors TNF-α, IL-2 and IFN-γ in endometrial cells of RSA patients were significantly increased after intrauterine lavage intervention compared with those of normal women in early pregnancy (P<0.05). After the intervention of intrauterine lavage with extravillous trophoblast cells in RSA patients, the number of invasive cells and migration area of cells were significantly decreased compared with that of normal women in early pregnancy (P<0.05). Conclusions: The uterine cavity of patients with RSA presents a microinflammatory state, which affects the invasion and migration ability of extravillous trophoblast cells and is not conducive to the maintenance of pregnancy.

Key words: Abortion, habitual, Pregnancy, Cellular microenvironment, Cytokines, Intrauterine lavage