CAJ | 학술논문

目的：探讨Th1/Th2亚群失衡在原因不明性复发性自然流产（ URSA）中的作用及补肾固冲方逆转Th1/Th2亚群失衡治疗URSA的作用及分子机制。方法：URSA患者30例，给予补肾固冲方治疗，正常妊娠妇女30例为正常对照组，流式细胞术胞内外双染色法检测URSA患者治疗前后及正常妊娠妇女外周血Th1/Th2亚群分化状态，RT-PCR法检测Th1亚群特异性核转录因子T-bet、Th2亚群特异性核转录因子GATA-3mRNA转录水平。结果：与正常妊娠妇女比较，URSA患者外周血Th1亚群比例显著升高（P＜0.05），Th2亚群比例显著降低（P＜0.05），Th1/Th2比率显著升高（P＜0.05）。补肾固冲方治疗后， URSA患者Th1亚群比例及T-bet转录水平显著降低（P＜0.05），Th2亚群比例及GATA-3转录水平显著升高（P＜0.05），Th1/Th2比率明显降低（ P＜0.05）。相关性分析显示，URSA患者治疗后子宫出血天数与Th1亚群比例呈显著正相关（ P＜0.05），与Th2亚群比例呈负相关，与Th1/Th2亚群呈正相关。结论：URSA患者存在Th1/Th2亚群失衡，补肾固冲方通过上调T-bet转录水平、下调GATA-3转录水平，优势诱导Th2亚群分化，逆转Th1/Th2亚群失衡，进而治疗URSA。
목적：탐토Th1/Th2아군실형재원인불명성복발성자연유산（ URSA）중적작용급보신고충방역전Th1/Th2아군실형치료URSA적작용급분자궤제。방법：URSA환자30례，급여보신고충방치료，정상임신부녀30례위정상대조조，류식세포술포내외쌍염색법검측URSA환자치료전후급정상임신부녀외주혈Th1/Th2아군분화상태，RT-PCR법검측Th1아군특이성핵전록인자T-bet、Th2아군특이성핵전록인자GATA-3mRNA전록수평。결과：여정상임신부녀비교，URSA환자외주혈Th1아군비례현저승고（P＜0.05），Th2아군비례현저강저（P＜0.05），Th1/Th2비솔현저승고（P＜0.05）。보신고충방치료후， URSA환자Th1아군비례급T-bet전록수평현저강저（P＜0.05），Th2아군비례급GATA-3전록수평현저승고（P＜0.05），Th1/Th2비솔명현강저（ P＜0.05）。상관성분석현시，URSA환자치료후자궁출혈천수여Th1아군비례정현저정상관（ P＜0.05），여Th2아군비례정부상관，여Th1/Th2아군정정상관。결론：URSA환자존재Th1/Th2아군실형，보신고충방통과상조T-bet전록수평、하조GATA-3전록수평，우세유도Th2아군분화，역전Th1/Th2아군실형，진이치료URSA。
Objective:To investigate the role of Th1/Th2 shift in unexplained recurrent spontaneous abortion (URSA) and to study the effect and molecular mechanism of Bushen Guchong decoction on URSA treatment by regulating Th 1/Th2 paradigm.Methods:30 cases of URSA patients were given Bushen Guchong decoction administration ; meanwhile,30 cases of normal pregnancy women were taken as control group.Th1/Th2 paradigm in peripheral blood monocytes of URSA patients before and after Bushen Guchong decoction administration was detected by flow cytometry.Moreover,the mRNA expression of the specific transcription factors for Th1 and Th2 subsets -T-bet and GATA-3 were detected by RT-PCR assay.Furthermore,the relationship between the Th1/Th2 paradigm and the uterine bleeding time after Bushen Guchong decoction administration was analyzed by Pearson correlation and re -gression tests.Results: Compared with normal pregnancy women , the proportion of Th1 subset of URSA patients was increased significantly (P<0.05),while the proportion of Th2 subset was decreased markedly (P<0.05).Additionally,the ration of Th1/Th2 subsets was increased in URSA women (P<0.05).After Bushen Guchong decoction treatment ,the proportion of Th1 subsets in URSA patients and T-bet mRNA expression were up-regulated significantly ( P<0.05 ) , whereas the Th2 proportion and GATA-3 mRNA expression were down-regulated obviously (P<0.05).Moreover,the ratio of Th1/Th2 was decreased significantly (P<0.05).Correlation analysis showed that the uterine bleeding time was positively related to both the proportion of Th 1 and the ratio of Th1/Th2, while negatively related to the proportion of Th 2 subsets.Conclusion:Th1/Th2 shift was involved in URSA.Bushen Guchong decoction up-regulated the transcription level of GATA-3 and down-regulated the transcription level of T-bet.Thereby, Bushen Guchong decoction exerted the curative effect on URSA by revising Th 1/Th2 shift.