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目的:探讨排卵期生殖道局部细胞免疫与黄体功能不全(LPD)患者不孕之间的关系,旨在为临床防治不孕不育提供依据及参考。方法:选择2014年10月~2015年10月本院确诊的LPD患者50例为观察组,同期筛选同期50例健康体检者为对照组,排卵后第4 d、6 d、8 d采用酶联免疫法检测两组排卵期血清孕酮(P)水平,采用放射免疫法(RIA)检测两组排卵期血清以及宫颈黏液中的肿瘤坏死因子-α(TNF-α)与白细胞介素1-β(IL-1β)的表达水平,对以上检测指标予以比较分析。结果:排卵后第4d、6d、8d观察组血清P明显低于对照组,比较差异均有统计学意义(P<0.05)。排卵期观察组血清TNF-α及IL-1β水平与对照组比较,差异不具有统计学意义(P>0.05),但观察组宫颈黏液中TNF-α及IL-1β水平显著高于对照组,差异有统计学意义(P<0.05)。排卵期观察组宫颈黏液中TNF-α、IL-1β水平与血清P存在负相关关系(r=-0.879,-0.886,P<0.05),且宫颈黏液中TNF-α、IL-1β二者存在显著正相关关系(r=0.768,P<0.05)。结论:排卵期生殖道局部细胞免疫激活,宫颈黏液中TNF-α及IL-1β水平升高,对黄体发育产生影响,并导致LPD的发生。
Objective: To investigate the relationship between local cellular immunity in ovulation period genital tract and infertility in patients with luteal phase dysfunction (LPD), and to provide basis and references for clinical prevention and treatment of infertility. Methods: Fifty patients with LPD diagnosed in our hospital from October 2014 to October 2015 were selected as the observation group. Fifty healthy subjects were selected as the control group during the same period. The control group was selected on the 4th, 6th and 8th day after ovulation. Serum progesterone (P) levels in ovulation period were detected by immunohistochemistry. Serum levels of ovulation and tumor necrosis factor-α (TNF-α) and interleukin 1 -β (IL-1β) expression levels, to compare the above test indicators. Results: Serum P in the observation group after 4, 6 and 8 days of ovulation was significantly lower than that of the control group (P <0.05). The levels of serum TNF-α and IL-1β in ovulation observation group were not significantly different from those in control group (P> 0.05), but the levels of TNF-α and IL-1β in cervical mucus of observation group were significantly higher than those in control group The difference was statistically significant (P <0.05). Ovulation observation group cervical mucus TNF-α, IL-1β levels and serum P negative correlation (r = -0.879, -0.886, P lt; 0.05), and cervical mucus in the presence of both TNF-α, IL- Significant positive correlation (r = 0.768, P <0.05). CONCLUSION: Local cellular immunity in the genital tract during ovulation and elevated levels of TNF-α and IL-1β in cervical mucus have effects on the development of corpus luteum and lead to the occurrence of LPD.