CAJ | 학술논문

目的：探讨原因不明习惯性流产(recurrent spontaneous abortion, RSA)患者肿瘤坏死因子-α(TNF-α)和转化生长因子-β( TGF-β)表达及临床意义。方法选择2011年1月—2013年6月在我院妇科门诊就诊的原因不明RSA 60例作为原因不明RSA组,另选择同期在我院妇科门诊就诊要求人工流产的正常妊娠妇女70例作为正常妊娠组。两组均应用酶联免疫吸附法(enzyme-linked immunosorbent assay, ELISA)检测外周血中TNF-α与TGF-β表达并比较；应用免疫组织化学法检测蜕膜及绒毛组织中TNF-α与TGF-β蛋白表达并比较。结果 ELISA检测结果显示,外周血中TNF-α原因不明RSA组为(213.69±4.17)ng/ml 明显高于正常妊娠组(135.14±5.38)ng/ml,外周血中TGF-β原因不明RSA 组为(240.32±3.27)ng/ml明显低于正常妊娠组(403.05±6.71)ng/ml,两组比较差异均有统计学意义(P<0．05)。免疫组织化学法检测结果显示,两组蜕膜组织TNF-α蛋白均呈阴性表达,绒毛组织均表达TNF-α蛋白,绒毛组织中TNF-α蛋白的表达原因不明RSA组明显高于正常妊娠组,两组比较差异有统计学意义(P<0．05)；两组绒毛组织合体滋养层细胞均表达TGF-β蛋白,绒毛组织中TGF-β蛋白的表达原因不明RSA组明显低于正常妊娠组,两组比较差异有统计学意义(P<0．05)；两组蜕膜组织均弱阳性表达TGF-β蛋白,蜕膜组织中TGF-β蛋白的表达原因不明RSA组低于正常妊娠组,但两组比较差异无统计学意义(P>0．05)。结论外周血及绒毛组织中TNF-α增多、TGF-β减少可能与原因不明RSA有关。
목적：탐토원인불명습관성유산(recurrent spontaneous abortion, RSA)환자종류배사인자-α(TNF-α)화전화생장인자-β( TGF-β)표체급림상의의。방법선택2011년1월—2013년6월재아원부과문진취진적원인불명RSA 60례작위원인불명RSA조,령선택동기재아원부과문진취진요구인공유산적정상임신부녀70례작위정상임신조。량조균응용매련면역흡부법(enzyme-linked immunosorbent assay, ELISA)검측외주혈중TNF-α여TGF-β표체병비교；응용면역조직화학법검측세막급융모조직중TNF-α여TGF-β단백표체병비교。결과 ELISA검측결과현시,외주혈중TNF-α원인불명RSA조위(213.69±4.17)ng/ml 명현고우정상임신조(135.14±5.38)ng/ml,외주혈중TGF-β원인불명RSA 조위(240.32±3.27)ng/ml명현저우정상임신조(403.05±6.71)ng/ml,량조비교차이균유통계학의의(P<0．05)。면역조직화학법검측결과현시,량조세막조직TNF-α단백균정음성표체,융모조직균표체TNF-α단백,융모조직중TNF-α단백적표체원인불명RSA조명현고우정상임신조,량조비교차이유통계학의의(P<0．05)；량조융모조직합체자양층세포균표체TGF-β단백,융모조직중TGF-β단백적표체원인불명RSA조명현저우정상임신조,량조비교차이유통계학의의(P<0．05)；량조세막조직균약양성표체TGF-β단백,세막조직중TGF-β단백적표체원인불명RSA조저우정상임신조,단량조비교차이무통계학의의(P>0．05)。결론외주혈급융모조직중TNF-α증다、TGF-β감소가능여원인불명RSA유관。
Objective To investigate the expression levels and clinical significance of TNF-α and TGF-β in women with unknown aetiology recurrent spontaneous abortion ( RSA) . Methods 60 women with unknown aetiology RSA admitted to our hos-pital during January 2011 and June 2013 were chosen as unknown aetiology RSA group and 70 normal pregnant women of artificial a-bortion admitted to our hospital during January 2011 and June 2013 were chosen as normal pregnant group. Enzyme-linked immu-nosorbent assay ( ELISA) was used to evaluate the protein levels of TNF-α and TGF-β in peripheral blood of unknown aetiology RSA group and normal pregnant group. The protein levels of TNF-αand TGF-βin villous and decidual tissues of unknown aetiology RSA group and normal pregnant group were tested using immunohistochemistry staining. Results ELISA result showed that the lev-el of TNF-αin peripheral blood of unknown aetiology RSA group was increased significantly as compared with that of normal preg-nant group [(213. 69 ± 4. 17)ng/ml vs. (135. 14 ± 5. 38)ng/ml, P<0. 05], whereas the level of TGF-βin peripheral blood of un-known aetiology RSA group was significantly lower than that of normal pregnant group [(240. 32 ± 3. 27) ng/ml vs. (403. 05 ± 6. 71)ng/ml, P<0. 05]. Immunohistochemistry staining result showed that the TNF-αprotein was expressed in villous issues of the two groups, and decidual cells of the two groups showed negative expression of TNF-α, the expression of TNF-αin villous tissues of unknown aetiology RSA group was significantly higher than that in normal pregnant group (P<0. 05);TGF-βexpression in the two groups were villus syncytiotrophoblast cells, the expression of TGF-βin villous tissues of unknown aetiology RSA group was signifi-cantly lower than that in normal pregnant group (P<0. 05);Decidual tissues of two groups showed weak positive expression of TGF-β, the expression of TGF-βin decidual tissues of RSA group was lower than that in normal pregnant group, however, there was no statistically significant difference between the two groups (P>0. 05). Conclusion The increase of expression of TNF-α and the expression of TGF-βin peripheral blood and decidual tissues may be involved in the pathogenesis of unknown aetiology RSA.