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目的检测复发性胚胎停育患者淋巴细胞主动免疫前后KIR2DL4基因的表达的变化,探讨反复性胚胎停育免疫学原因。方法选择2011年6月至2012年6月就诊的2次以上早孕胚胎停育的患者,根据以往有无人工流产和/或者分娩史分为无妊娠史(无人工流产及分娩史)组30例;有妊娠史(有人工流产史及分娩史)组55例;对照组为正常无妊娠史的未孕妇女30例。对研究者进行淋巴细胞主动免疫治疗4个周期后,采用荧光实时定量PCR技术检测治疗前后患者的淋巴细胞的KIR2DL4基因的表达。随访研究者妊娠结局。结果 (1)两组胚胎停育组治疗前KIR2DL4基因表达无妊娠史组为(43.55±12.71×103/ml)、有妊娠史组为(21.48±9.43×103/ml),分别与对照组(55.35±12.68×103/ml)比较,差异有统计学意义(P<0.05);两组胚胎停育组经淋巴细胞主动免疫治疗后KIR2DL4基因的表达分别为(56.76±10.90×103/ml、67.89±11.39×103/ml)与对照组治疗后(70.84±13.47×103/ml)比较,差异无统计学意义(P>0.05)。两组胚胎停育组免疫治疗前后比较KIR2DL4基因比较差异有统计学意义(P<0.05)。(2)免疫治疗前有妊娠史胚胎停育组KIR2DL4基因的表达(21.48±9.43×103/ml),与无妊娠史胚胎停育组KIR2DL4基因表达(43.55±12.71×103/ml)比较,差异有统计学意义(P<0.05),主动免疫治疗后差异无统计学意义(P>0.05)。(3)随访结果:两组胚胎停育组免疫治疗结束后,每组妊娠患者中,胚胎停育率分别为21.74%,18.75%;对照组胚胎停育率为20%。胚胎停育率比较差异无统计学意义(P>0.05)。结论淋巴细胞KIR2DL4基因的表达数量异常与反复性胚胎停育有关。
Objective To detect the changes of KIR2DL4 gene expression before and after active immunization of lymphocytes in patients with recurrent embryo outpatients to investigate the immunological reasons of recurrent embryo suspension. Methods From June 2011 to June 2012, two or more patients with early embryo implantation were divided into three groups according to whether there was any history of manual abortion and / or childbirth before pregnancy (no history of artificial abortion and childbirth). ; There was a history of pregnancy (history of abortion and childbirth history) group of 55 cases; control group of normal pregnant women without pregnancy history of 30 cases. After 4 cycles of active lymphocyte immunotherapy, the real-time quantitative PCR was used to detect the expression of KIR2DL4 gene in lymphocytes of patients before and after treatment. Follow-up investigators pregnancy outcome. Results (1) The expression of KIR2DL4 gene in pre-treatment and control groups was (43.55 ± 12.71 × 103 / ml) and (21.48 ± 9.43 × 103 / ml) respectively before treatment in control group 55.35 ± 12.68 × 103 / ml), the difference was statistically significant (P <0.05). The expression of KIR2DL4 gene in activated group after immunization with lymphocytes in two groups were (56.76 ± 10.90 × 103 / ml, 67.89 ± 11.39 × 103 / ml) compared with the control group after treatment (70.84 ± 13.47 × 103 / ml), the difference was not statistically significant (P> 0.05). There were significant differences in KIR2DL4 gene expression between the two groups before and after immunotherapy (P <0.05). (2) The expression of KIR2DL4 gene in preimpregnation group (21.48 ± 9.43 × 103 / ml) before immunotherapy was significantly different from that in KIR2DL4 non-pregnancy embryos group (43.55 ± 12.71 × 103 / ml) There was statistical significance (P <0.05), no significant difference after active immunization (P> 0.05). (3) The follow-up results: After the immunotherapy of two groups of embryo stop group immunization, in each group of pregnancy patients, the embryo suspension rates were 21.74% and 18.75% respectively; the control group embryo implantation rate was 20%. There was no significant difference in embryo stop rate (P> 0.05). Conclusion The abnormal expression of KIR2DL4 gene in lymphocytes is related to the arrest of repeated embryos.