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目的:探讨血清基质细胞衍生因子(CXCL12)、单核细胞趋化蛋白-1(CCL2)、调节活化正常T细胞表达和分泌因子(RANTES)和孕酮在胚胎停育早期诊断中的作用。方法:选择2008年6月~2009年6月在天津医科大学第二医院计划生育科因胚胎停育就诊的患者26例(胚胎停育组)以及同孕龄正常早孕妇女30例(对照组),采用酶联免疫技术检测血清CXCL12、CCL2和RANTES的蛋白含量,采用化学发光免疫分析技术检测血清孕酮的水平。结果:胚胎停育组血清CXCL12的蛋白含量为(194.52±29.23)pg/ml,低于对照组[(268.13±26.36)pg/ml],差异有统计学意义(P<0.05);CCL2和RANTES的蛋白含量分别为(83.34±10.6l)pg/ml和(117.29±18.67)pg/ml,高于对照组[(59.41±9.70)pg/ml和(79.88±12.54)pg/ml],差异均有统计学意义(P<0.05)。血清孕酮水平为(29.66±6.41)ng/ml,低于对照组[(10.06±2.86)ng/ml],差异有统计学意义(P<0.05)。两组血清CXCL12值与孕酮值呈正相关关系(γ=0.765,P<0.05);血清CCL2、RANTES值与孕酮值呈负相关关系(γ=-0.703,P<0.05;γ=-0.692,P<0.05)。结论:联合单次检测血清CXCL12、CCL2、RANTES和孕酮在胚胎停育的早期诊断中具有重要的临床意义,孕激素可能对早孕母胎界面趋化因子CXCL12、CCL2、RANTES有免疫调节作用。
Objective: To explore the role of serum CXCL12, CCL2, RANTES and progesterone in the early diagnosis of embryo shutdown. Methods: Twenty-six patients (embryo stop group) and 30 normal pregnant women (control group) who were treated by the family planning family planning department of the Second Hospital of Tianjin Medical University from June 2008 to June 2009 were enrolled in this study. The protein levels of serum CXCL12, CCL2 and RANTES were detected by enzyme linked immunosorbent assay (ELISA), and the level of serum progesterone was detected by chemiluminescence immunoassay. Results: The protein level of serum CXCL12 in embryo stop group was (194.52 ± 29.23) pg / ml, which was lower than that in control group [(268.13 ± 26.36) pg / ml] (83.34 ± 10.61) pg / ml and (117.29 ± 18.67) pg / ml, respectively, which were higher than that of the control group [(59.41 ± 9.70) pg / ml and (79.88 ± 12.54) pg / ml] There was statistical significance (P <0.05). The level of serum progesterone was (29.66 ± 6.41) ng / ml, which was lower than that of the control group [(10.06 ± 2.86) ng / ml], the difference was statistically significant (P <0.05). There was a positive correlation between serum CXCL12 and progesterone (γ = 0.765, P <0.05). There was a negative correlation between serum CCL2 and RANTES and progesterone (γ = -0.703, P <0.05; P <0.05). CONCLUSION: The combination of single serum CXCL12, CCL2, RANTES and progesterone has important clinical significance in the early diagnosis of embryo shutdown. Progesterone may have immunomodulatory effects on the expression of CXCL12, CCL2 and RANTES.