子宫内膜异位症与免疫不孕的相关性研究

发布时间：2018-01-12 21:36

  本文关键词：子宫内膜异位症与免疫不孕的相关性研究　出处：《青岛大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 子宫内膜异位 免疫性不孕 性激素 免疫抗体 免疫细胞因子

【摘要】：目的:通过测定子宫内膜异位症与不孕患者内分泌激素、免疫细胞及分子的表达水平,探讨子宫内膜异位症与免疫性不孕的相关性。方法:选取临沂市中医医院2013年10月-2015年01月收治的114例有子宫内膜异位症和(或)不孕患者。按其疾病类型分为单纯子宫内膜异位症组(A组,38例)、单纯不孕症组(B组,38例)、子宫内膜异位症合并不孕组(C组,38例),同时以38例年龄相仿的健康女性作为对照组(D组)。采用化学发光免疫法测定患者的血清中的T、E2、PRL、FSH以及LH和INS水平。利用酶联免疫吸附(ELISA)法检测用每项观察指标的特定试剂盒对患者的ASAb、EMAb、AOAb、HCGAb以及ACAb,细胞因子IL-4、IL-6、IL-8、TNF-α、IFN,补体C3 C4,采用流式细胞术检测患者外周血CD3+CD4+CD8+T细胞亚群。对不同组别的患者进行以上指标的比较,分析子宫内膜异位症与免疫性不孕的相关性。结果:⑴C组患者中的T、E2、PRL以及INS水平均显著高于A组和B组患者,差异有统计学意义(P0.05),FSH和LH的水平3组无统计学差异(P0.05);对照组以及B组的PRL水平显著低于A组患者,差异有统计学意义(P0.05),其他各指标差异均无统计学意义(P0.05)。⑵C组的抗体总阳性率显著高于其他3组,差异有统计学意义(P0.05),A组与B组之间的抗体阳性率差异无统计学意义(P0.05)。但均高于对照组(P0.05)。⑶C组的细胞因子的浓度滴度要显著高于其他三组,差异具有统计学差异(P0.05),A组与B组之间的细胞因子滴度差异无统计学意义(P0.05),但均高于健康对照组,存在显著差异(P0.05)。⑷C组中各个体液的免疫指标中Ig G、Ig A、Ig M、C3、C4均显著高于其他三组,且存在统计学差异,(P0.05)。同B组和健康对照组相比较,A组中各个体液免疫指标中Ig G、Ig A、Ig M、C3、C4明显偏高,且存在统计学上的差异,(P0.05)。B组和健康对照组不存在统计学上差异,(P0.05)。⑸C组中外周血中CD3+、CD4+、CD8+和CD4+/CD8+均显著低于其他三组,存在显著的统计学差异,(P0.05)。A组中外周血中CD3+、CD4+、CD8+和CD4+/CD8+均显著低于B组和健康对照组,存在显著的统计学差异(P0.05)。B组和健康对照组不存在统计学上差异,(P0.05)结论:⑴子宫内膜异位合并不孕的患者性激素水平异常增高,说明激素的紊乱与子宫内膜异位患者不孕密切相关。⑵子宫内膜异位合并不孕的患者自身抗体增高,说明自身免疫损伤可能参与不孕的发生。⑶CD4+CD8+T细胞紊乱及IL-4 IL-6 IL-8炎性细胞因子导致的炎症反应及C3 C4的炎性介质作用可促进子宫内膜异位症患者不孕症的发生⑷不孕症的发生是多因素共同作用的结果,子宫内膜异位致内分泌激素及免疫细胞、免疫分子功能紊乱,造成内分泌-免疫网络失衡是导致不孕的关键因素
[Abstract]:Objective: to determine the expression of endocrine hormones, immunocytes and molecules in patients with endometriosis and infertility. To explore the relationship between endometriosis and immunological infertility methods: 114 cases of endometriosis and / or endometriosis were selected from October 2013 to January 2015 in Linyi traditional Chinese Medicine Hospital. Infertility patients. According to their disease type, divided into simple endometriosis group, group A. 38 cases of endometriosis with infertility, 38 cases of group B with simple infertility, 38 cases of group C with endometriosis and infertility). At the same time, 38 healthy women of the same age were used as the control group D to determine the serum TV-E2P PRL by chemiluminescent immunoassay. The levels of FSH and LH and INS were detected by Elisa. The Asab EMAbAbAOAb of patients was detected with a specific kit of each observed indicator. HCGAb and ACAB, cytokine IL-4, IL-6, IL-8, TNF- 伪, complement C3 C4. The subsets of CD3 CD4 CD8 T cells in peripheral blood were detected by flow cytometry. The above indexes were compared among different groups of patients. Results the levels of INS and INS in group 1: 1 were significantly higher than those in group A and group B. There was no significant difference in the levels of FSH and LH among the three groups. The level of PRL in control group and group B was significantly lower than that in group A (P 0.05). The total positive rate of antibody was significantly higher in P0.05C group than that in the other three groups (P 0.05). There was no significant difference in antibody positive rate between group A and group B, but the titer of cytokines in group A was significantly higher than that in group C (P 0.05). There was no significant difference in cytokine titer between group A and group B, but it was higher than that in healthy control group. There was significant difference in the immunological index of each humoral fluid in group P0.05. 4C, which was significantly higher than that in the other three groups, and there was statistical difference. Compared with group B and healthy control group, the levels of Ig G G, Ig MN C 3 C 3 C 4 in group A were significantly higher than those in group A, and there were statistical differences between them. There was no statistical difference between group B and control group in CD3 CD4 in peripheral blood. CD8 and CD4 / CD8 were significantly lower than the other three groups, there was a significant statistical difference in CD3 CD4 in peripheral blood of P0.05. A group. CD8 and CD4 / CD8 were significantly lower than group B and healthy control group, there was significant statistical difference. There was no statistical difference between group B and group B and healthy control group. Conclusion: the level of sex hormone in patients with endometriosis complicated with infertility is abnormally high. It is suggested that the disorder of hormones is closely related to infertility in endometriosis. 2. The autoantibodies of patients with endometriosis combined with infertility are higher than those of patients with endometriosis. It is suggested that autoimmune injury may be involved in the occurrence of infertility. 3CD4 CD8 T cell disorder and IL-4 IL-6 IL-8 inflammatory cytokines and C3. The inflammatory mediators of C4 can promote the occurrence of infertility in patients with endometriosis. 4 the occurrence of infertility is the result of multiple factors. Endocrine hormones and immune cells caused by endometriosis are the key factors leading to infertility due to the disturbance of immune molecule function and the imbalance of endocrine and immune network.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R711.71;R711.6
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本文编号：1416134