加味寿胎丸联合黄体酮调节NKG2D、NKG2A表达治疗肾虚型URSA作用机制研究

发布时间：2018-04-11 23:20

本文选题：加味寿胎丸 + 黄体酮　；参考：《南京中医药大学学报》2017年05期

【摘要】：目的探讨NK细胞活性变化在不明原因复发性流产(URSA)发病中的机制;加味寿胎丸联合黄体酮通过调节NK细胞受体表达变化诱导母胎免疫耐受治疗URSA的作用机制。方法选取加味寿胎丸联合黄体酮治疗肾虚型URSA成功患者20例,并选取同期URSA妊娠丢失组及健康早孕(HEP)组各15例,以流式细胞术检测各组外周血NKG2D、NKG2A的表达,并比较URSA妊娠组治疗后与健康早孕组血E2、P、β-HCG水平。结果 URSA妊娠丢失组pNK细胞NKG2D呈高表达及NKG2A呈低表达,与HEP组比较有显著统计学意义(P0.01)。URSA妊娠组治疗后pNK细胞NKG2D表达水平明显低于治疗前,与HEP组比较有统计学意义(P0.05),与URSA妊娠丢失组比较有显著统计学意义(P0.01);NKG2A表达水平明显高于治疗前(P0.01),与HEP组比较无统计学意义,与URSA妊娠丢失组比较有显著统计学意义(P0.01)。经加味寿胎丸联合黄体酮治疗后,URSA妊娠组血清E2、P、β-HCG水平与HEP组分别比较,差异均无统计学意义(P0.05)。结论NK细胞受体NKG2D、NKG2A的表达参与了URSA的发病;加味寿胎丸联合黄体酮能通过下调URSA患者NKG2D的表达水平,上调NKG2A的表达水平介导母胎免疫耐受治疗URSA;固肾安胎法是治疗肾虚型URSA的有效方法,加味寿胎丸是治疗肾虚型URSA的有效方剂。
[Abstract]:Objective to investigate the mechanism of the change of NK cell activity in the pathogenesis of unexplained recurrent abortion (Ursa) and the mechanism of Jiawei Shoufei pill combined with progesterone in inducing maternal and fetal immune tolerance to URSA by regulating the expression of NK cell receptor.Methods A total of 20 successful URSA patients with kidney deficiency were treated with modified Shou-Feiwan combined with progesterone, 15 with URSA pregnancy loss and 15 with healthy early pregnancy. Flow cytometry was used to detect the expression of NKG2-DnkG2A in peripheral blood of each group.The serum levels of E2P, 尾-HCG in URSA pregnancy group were compared with those in healthy early pregnancy group.Results the expression of NKG2D and NKG2A in pNK cells in URSA pregnancy loss group was higher than that in HEP group. Compared with HEP group, the NKG2D expression level of pNK cells in HEP group was significantly lower than that in HEP group.Compared with the HEP group, the expression level of NKG2A was significantly higher in the URSA pregnancy loss group than in the HEP group, but not in the HEP group, and was significantly higher than that in the URSA pregnancy loss group.The serum levels of E2P and 尾 -HCG in Ursa pregnancy group were not significantly different from those in HEP group after treatment with modified Shoufeiwan combined with progesterone.Conclusion the expression of NK cell receptor NKG2D- NKG2A is involved in the pathogenesis of URSA, and Jiawei Shouti pills combined with progesterone can down-regulate the expression of NKG2D in patients with URSA.Upregulation of NKG2A expression mediates maternal and fetal immune tolerance in the treatment of Ursa, the method of strengthening the kidney and the fetus is an effective method for the treatment of kidney deficiency type URSA, and Jiawei Shou-fetus pill is an effective prescription for the treatment of kidney deficiency type URSA.
【作者单位】：山东中医药大学第一临床医学院;山东中医药大学附属医院;山东省医学科学院基础医学研究所;
【基金】：山东省医药卫生科技发展计划(2015WS0134)
【分类号】：R714.21

【相似文献】