反复体外受精.docx

反复体外受精 作者：杨桂艳，姜英华，吴洪秋，曾伟荣 【关键词】 T辅助细胞　　摘要：目的：研究不明原因反复体外受精―胚胎移植(试管婴儿，IVF-ET)失败的患者机体T辅助细胞1（Th1）及T辅助细胞2(Th2)免疫应答方式，为治疗不明原因反复体外受精-胚胎移植失败提供理论依据。方法：将不明原因的三次及三次以上IVF-ET失败的患者作为研究对象，一个周期IVF-ET成功妊娠的患者作为对照组，抽取非治疗周期静脉血分离单个核细胞并于37℃，5%CO2培养箱中培养72h，分离上清，ELISA法测定上清液中INF-γ/IL10含量，计算INF-γ/IL10的比值，从而反映机体Th1、Th2细胞的免疫应答方式。结果：反复IVF-ET失败的患者9例中有7例TH1细胞因子（INF-γ）浓度是Th2细胞因子（IL10）的3倍，有显著性差异；反复IVF-ET失败的患者9例中有4例机体Th1细胞因子（INF-γ）是Th2细胞因子（IL10）的9倍，呈Th1强势反应，而对照组9例中仅1例且发生早期流产，有统计学意义。结论：部分反复体外受精-胚胎移植失败的患者机体Th1 Th2免疫应答失衡，呈Th1优势反应，提示细胞免疫过强。　　关键词： 反复体外受精-胚胎移植失败； T辅助细胞； 优势反应　　Study on T Helper Cell Immune Response Type in Women with Unexplained Recurrent IVF-ET Failure　　Abstract： Objective：To study the Th1 and Th2 response type in women with unexplained recurrent IVF-ET failure, and to provide theoretic evidence on dealing with recurrent IVF-ET failure. Method： Blood sample was taken from 9 women received 3 unexplained failure IVF-ET cycles (study group), while 9 women with successful IVF-ET cycle being controlled. The lymphocyte was separated, and then was cultured at 37℃，5%CO2 for 72 hours, concentration of INF-γ,IL10 was measured by ELISA，the INF-γ/IL10 rate was calculated. Result： 7 from 9 in study group had INF-γ/IL10 rate more than 3, while only 2 from 9 in control group and 4 from 9 in study group had INF-γ/IL10 rate more than 9, while only 1 from 9 in control group and the patient got early abortion. Conclusion： Large partial women with unexplained recurrent IVF-ET failure had T helper cell immune respond imbalance. Th1 cytokines was strong response in large partial women with unexplained recurrent IVF-ET failure, and it was obvious in some patients.　　Key words： Reccurent unexplained IVF-ET failure； T helper cell； Strong response　　体外受精-胚胎移植是一种有效的使输卵管阻塞、男方少弱精及各类难治性不孕症夫妇喜得后代的技术，其一个治疗周期的妊娠率达40%左右，累计妊娠率高达80%，已知的反复植入失败的原因有：年龄过大卵子老化、卵巢反应不良可供选择的优质胚胎少、子宫内膜严重受损、输卵管积水等，但也有一些患者虽然植入优质胚胎、子宫内膜正常、染色体检查正常仍然反复种植失败，有学者认为与机体的免疫状态有关，因此我们研究了反复不明原因种植失败的患者血清中单个核细胞的INF-γ/IL10的含量及比值了解 T 辅助细胞的免疫