【摘要】 目的探讨复发性流产患者巨噬细胞移动抑制因子(MIF)、Toll样受体4(TLR4)的表达及其临床意义。方法选取2016年3月～2018年3月西安交通大学第二附属医院收治的复发性流产患者48例设为复流组,选取同期48例人工流产的正常妊娠妇女设为对照组,采用免疫组化链霉菌抗生物素蛋白-过氧化物酶连接法检测蜕膜组织中MIF、TLR4表达水平,采用酶联免疫吸附法检测血清MIF水平,比较两组MIF、TLR4水平。结果对照组蜕膜组织的病理HE染色可见结构清晰、完整,复流组蜕膜组织结构水肿、变性、缺损、炎性细胞浸润及滋养细胞增生、变性、坏死;蜕膜组织和血清中MIF水平明显低于对照组,复流组蜕膜组织TLR4水平明显高于对照组,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,蜕膜组织和血清中MIF与TLR4水平呈负相关(P<0.05)。结论复发性流产可能导致了蜕膜组织和血清MIF、TLR4的异常表达,MIF、TLR4在复发性流产发病中可能存在相互影响作用,提示MIF低表达和TLR4高表达可能可作为评估复发性流产发生的重要参考指标。更多还原

【Abstract】 Objective To discuss the expression and clinical significance of macrophage migration inhibitory factor(MIF) and Toll like receptor 4(TLR4) in patients with recurrent spontaneous abortion. Methods 48 patients with recurrent spontaneous abortion were selected as the reflow group from March 2016 to March 2018 in The Second Affiliated Hospital of Xi’an Jiao Tong University. 48 normal pregnant women with induced abortion were selected as control group at the same time. The expression of MIF and TLR4 in the decidua tissue was detected by immunohistochemical streptomyces avidin peroxidase linked method. The serum MIF level was detected by enzyme-linked immunosorbent assay method. The MIF and TLR4 levels were compared between the two groups. Results The pathological HE staining of decidua in control group showed clear and complete. The villous structure in reflow group was structural defect, edema, degeneration, infiltration of inflammatory cells and degeneration, necrosis and hyperplasia of trophoblast cells. The decidua tissue and serum MIF level in the reflow group were significantly lower than those in the control group. The decidua tissue TLR4 level in the reflow group was significantly higher than that in the control group(P<0.05). The Pearson correlation analysis results showed that the decidua tissue and serum MIF level were negatively correlated withTLR4(P<0.05). Conclusions The decidua tissue and serum MIF and TLR4 may be involved in the onset of recurrent abortion, and the low expression of MIF and high expression of TLR4 may be the important index for evaluating the occurrence of recurrent spontaneous abortion.更多还原