胚胎停育患者绒毛组织中TLR2的表达与外周血中TNF-α、IL-6水平的关系及其在发病机制中的作用

发布时间：2018-06-04 01:09

本文选题：胚胎停育 + TLR2　；参考：《郑州大学》2014年硕士论文

【摘要】：研究背景胚胎停育(missed abortion)[1]:是指妊娠期胚胎发育停止，是一种组织滞留宫腔内未能及时自然排出，是一种常见的早期病理妊娠。给其家庭及社会带来很大的影响，近年来其发病呈上升趋势，更引起了临床各界的重视。国外就胚胎停育的母体因素、环境因素及遗传因素关注颇多，并在流行病学方面做了大量研究，认为母体本身的疾病、遗传、子宫及生殖器官的解剖结构异常、内分泌因素和胎儿宫内发育停滞是密切相关的。胚胎停育的发病机制复杂，影响因素颇多，，目前就国内外大量的研究讨论，其机制可能如遗传、免疫、代谢等异常因素，独立或同时的发生，都可能引起绒毛滋养细胞生长生存的环境，使其凋亡失衡。目前国内外对胚胎停育病因的研究事业大多停留在母血激素水平、染色体异常的报道，然而对母血中的感染因素的研究较少。如果妊娠组织母胎界面不能有效的识别、清除母源性病原体而受到有害抗原的侵袭，从而引起过度的免疫反应，均可能带来负面的妊娠结局。胚胎停育患者的绒毛滋养细胞的凋亡也可能参与其机制。目的通过观察绒毛组织中Toll样受体2（TLR2）在正常早期妊娠及胚胎停育同期的绒毛组织中的表达及母血血清中TMF-α、IL-6浓度水平变化的情况，探讨其相关性。方法 1、选取2013.03—2013.06，年龄24～40岁，平均30岁，宫内孕＜12周的胚胎停育患者30例为病例组（排出非感染引起胚胎停育的），在年龄24～40岁，平均30岁，宫内孕＜12周，由于社会因素行人工流产的患者30例为对照组。HE染色法区分绒毛及蜕膜组织，免疫组织化学检测两组绒毛组织TLR2的表达，酶联免疫吸附法（ELISA）测定两组母血血清中TNF-α、IL-6浓度水平。 2、采用SPSS17.0软件包进行数据的统计分析，以均数±标准差(x s)的形式来表示各组数据的平均灰度值。采用两组独立样本t检验、秩和检验，相关分析采用Pearson相关分析。检验水准：α＝0.05。结果 1、两组孕妇在其孕周、年龄、孕次相比，差异无显著性（P＞0.05）。 2、实验组母血TNF-α、IL-6水平（1272.74±41.41，21.84±0.94）均高于对照组（1130.38±122.16，18.32±0.87），差异均有统计学意义（P＜0.05）。 3、TLR2在实验组绒毛组织中的表达（70.06±30.39）显著高于对照组（54.53±20.00）（P＜0.05）； 4、病例组血清中IL-6、TNF-α的表达与绒毛组织中TLR2的表达呈线性正相关（r=0.820，P＜0.05；r=0.849，P＜0.05）。对照组血清中IL-6、TNF-α的表达与绒毛组织中TLR2的表达无相关性（r=0.148，P＞0.05；r=0.013，P＞0.05）。结论胚胎停育患者绒毛滋养层细胞TLR2表达升高与外周血血清中TNF-α、IL-6水平的表达升高密切相关。
[Abstract]:Research background Embryonic abortion [1]: gestational embryo development is stopped, is a kind of tissue retention in uterine cavity can not be excreted naturally, is a common early pathological pregnancy. It has a great influence on the family and society. In recent years, the incidence of the disease is on the rise, which has attracted the attention of all clinical circles. The maternal factors, environmental factors and genetic factors of fetal suspension have been paid more attention to abroad, and a large number of epidemiological studies have been done. It is believed that the diseases, heredity, anatomic structure of uterus and reproductive organs of the mother itself are abnormal. Endocrine factors and fetal intrauterine development stagnation are closely related. The pathogenesis of embryo suspension is complicated, and there are many influencing factors. At present, there are a lot of researches and discussions at home and abroad, and its mechanism may occur independently or simultaneously, such as genetic, immune, metabolic and other abnormal factors. Both of them may cause the growth and survival of chorionic trophoblastic cells, resulting in the imbalance of apoptosis. At present, most of the research on the cause of fetal suspension at home and abroad is focused on maternal blood hormone levels and chromosomal abnormalities. However, there are few studies on the infection factors in maternal blood. If the maternal and fetal interface of pregnancy tissue can not be recognized effectively, and the maternal pathogens are cleared and attacked by harmful antigens, which may lead to excessive immune response, all of them may bring negative pregnancy outcome. Apoptosis of chorionic trophoblast cells may also be involved in the mechanism of fetal arrest. Purpose The expression of Toll like receptor 2 (TLR2) in human chorionic villi and the level of TMF- 伪 IL-6 in maternal serum were observed in normal early pregnancy and fetal abortive period, and the correlation between TMF- 伪 and IL-6 in maternal blood serum was investigated by observing the expression of TLR2 in human chorionic villi. Method 1. Thirty cases of fetal arrest with intrauterine pregnancy < 12 weeks were selected as the case group, aged 2440 years (mean 30 years, 2013.03-2013.06, age 240-40 years, mean 30 years old, less than 12 weeks of intrauterine pregnancy). Thirty patients with induced abortion were divided into chorionic villi and decidua tissues by HE staining. The expression of TLR2 in chorionic villi of the two groups was detected by immunohistochemistry, and the serum TNF- 伪 -guan6 (IL-6) levels in maternal blood were determined by enzyme-linked immunosorbent assay (Elisa). 2. The statistical analysis of the data was carried out by SPSS17.0 software package, and the average gray value of each group was expressed in the form of mean 卤standard deviation x s. Two groups of independent sample t test, rank sum test and Pearson correlation analysis were used. Test level: 伪 0. 05. Result 1. There was no significant difference between the two groups in gestational weeks, age and pregnancy times (P > 0.05). 2, the levels of TNF- 伪 IL-6 in maternal blood in the experimental group were higher than those in the control group (1272.74 卤41.41 卤21.84 卤0.94), which were significantly higher than those in the control group (1130.38 卤122.16 卤18.32 卤0.87) (P < 0.05). 3The expression of TLR2 in the chorionic villi of the experimental group was 70.06 卤30.39, which was significantly higher than that in the control group (54.53 卤20.00, P < 0.05). 4. The expression of IL-6 TNF- 伪 in serum was positively correlated with the expression of TLR2 in chorionic villi (P < 0.05). There was no correlation between the expression of IL-6 TNF- 伪 and the expression of TLR2 in chorionic villi in the control group (P > 0. 05 P > 0. 013 P > 0. 05). Conclusion The increase of TLR2 expression in chorionic trophoblastic cells was closely related to the increase of TNF- 伪 and IL-6 expression in peripheral blood.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.2

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