本文選題：胚胎停育 + TLR2��； 參考：《鄭州大學》2014年碩士論文

【摘要】：研究背景 胚胎停育(missed abortion)[1]:是指妊娠期胚胎發(fā)育停止，是一種組織滯留宮腔內(nèi)未能及時自然排出，是一種常見的早期病理妊娠。給其家庭及社會帶來很大的影響，近年來其發(fā)病呈上升趨勢，更引起了臨床各界的重視。國外就胚胎停育的母體因素、環(huán)境因素及遺傳因素關注頗多，并在流行病學方面做了大量研究，認為母體本身的疾病、遺傳、子宮及生殖器官的解剖結構異常、內(nèi)分泌因素和胎兒宮內(nèi)發(fā)育停滯是密切相關的。胚胎停育的發(fā)病機制復雜，影響因素頗多，，目前就國內(nèi)外大量的研究討論，其機制可能如遺傳、免疫、代謝等異常因素，獨立或同時的發(fā)生，都可能引起絨毛滋養(yǎng)細胞生長生存的環(huán)境，使其凋亡失衡。目前國內(nèi)外對胚胎停育病因的研究事業(yè)大多停留在母血激素水平、染色體異常的報道，然而對母血中的感染因素的研究較少。如果妊娠組織母胎界面不能有效的識別、清除母源性病原體而受到有害抗原的侵襲，從而引起過度的免疫反應，均可能帶來負面的妊娠結局。胚胎停育患者的絨毛滋養(yǎng)細胞的凋亡也可能參與其機制。 目的 通過觀察絨毛組織中Toll樣受體2（TLR2）在正常早期妊娠及胚胎停育同期的絨毛組織中的表達及母血血清中TMF-α、IL-6濃度水平變化的情況，探討其相關性。 方法 1、選取2013.03—2013.06，年齡24～40歲，平均30歲，宮內(nèi)孕＜12周的胚胎停育患者30例為病例組（排出非感染引起胚胎停育的），在年齡24～40歲，平均30歲，宮內(nèi)孕＜12周，由于社會因素行人工流產(chǎn)的患者30例為對照組。HE染色法區(qū)分絨毛及蛻膜組織，免疫組織化學檢測兩組絨毛組織TLR2的表達，酶聯(lián)免疫吸附法（ELISA）測定兩組母血血清中TNF-α、IL-6濃度水平。 2、采用SPSS17.0軟件包進行數(shù)據(jù)的統(tǒng)計分析，以均數(shù)±標準差(x s)的形式來表示各組數(shù)據(jù)的平均灰度值。采用兩組獨立樣本t檢驗、秩和檢驗，相關分析采用Pearson相關分析。檢驗水準：α＝0.05。 結果 1、兩組孕婦在其孕周、年齡、孕次相比，差異無顯著性（P＞0.05）。 2、實驗組母血TNF-α、IL-6水平（1272.74±41.41，21.84±0.94）均高于對照組（1130.38±122.16，18.32±0.87），差異均有統(tǒng)計學意義（P＜0.05）。 3、TLR2在實驗組絨毛組織中的表達（70.06±30.39）顯著高于對照組（54.53±20.00）（P＜0.05）； 4、病例組血清中IL-6、TNF-α的表達與絨毛組織中TLR2的表達呈線性正相關（r=0.820，P＜0.05；r=0.849，P＜0.05）。對照組血清中IL-6、TNF-α的表達與絨毛組織中TLR2的表達無相關性（r=0.148，P＞0.05；r=0.013，P＞0.05）。 結論 胚胎停育患者絨毛滋養(yǎng)層細胞TLR2表達升高與外周血血清中TNF-α、IL-6水平的表達升高密切相關。
[Abstract]:Research background Embryonic abortion [1]: gestational embryo development is stopped, is a kind of tissue retention in uterine cavity can not be excreted naturally, is a common early pathological pregnancy. It has a great influence on the family and society. In recent years, the incidence of the disease is on the rise, which has attracted the attention of all clinical circles. The maternal factors, environmental factors and genetic factors of fetal suspension have been paid more attention to abroad, and a large number of epidemiological studies have been done. It is believed that the diseases, heredity, anatomic structure of uterus and reproductive organs of the mother itself are abnormal. Endocrine factors and fetal intrauterine development stagnation are closely related. The pathogenesis of embryo suspension is complicated, and there are many influencing factors. At present, there are a lot of researches and discussions at home and abroad, and its mechanism may occur independently or simultaneously, such as genetic, immune, metabolic and other abnormal factors. Both of them may cause the growth and survival of chorionic trophoblastic cells, resulting in the imbalance of apoptosis. At present, most of the research on the cause of fetal suspension at home and abroad is focused on maternal blood hormone levels and chromosomal abnormalities. However, there are few studies on the infection factors in maternal blood. If the maternal and fetal interface of pregnancy tissue can not be recognized effectively, and the maternal pathogens are cleared and attacked by harmful antigens, which may lead to excessive immune response, all of them may bring negative pregnancy outcome. Apoptosis of chorionic trophoblast cells may also be involved in the mechanism of fetal arrest. Purpose The expression of Toll like receptor 2 (TLR2) in human chorionic villi and the level of TMF- 偽 IL-6 in maternal serum were observed in normal early pregnancy and fetal abortive period, and the correlation between TMF- 偽 and IL-6 in maternal blood serum was investigated by observing the expression of TLR2 in human chorionic villi. Method 1. Thirty cases of fetal arrest with intrauterine pregnancy < 12 weeks were selected as the case group, aged 2440 years (mean 30 years, 2013.03-2013.06, age 240-40 years, mean 30 years old, less than 12 weeks of intrauterine pregnancy). Thirty patients with induced abortion were divided into chorionic villi and decidua tissues by HE staining. The expression of TLR2 in chorionic villi of the two groups was detected by immunohistochemistry, and the serum TNF- 偽 -guan6 (IL-6) levels in maternal blood were determined by enzyme-linked immunosorbent assay (Elisa). 2. The statistical analysis of the data was carried out by SPSS17.0 software package, and the average gray value of each group was expressed in the form of mean 鹵standard deviation x s. Two groups of independent sample t test, rank sum test and Pearson correlation analysis were used. Test level: 偽 0. 05. Result 1. There was no significant difference between the two groups in gestational weeks, age and pregnancy times (P > 0.05). 2, the levels of TNF- 偽 IL-6 in maternal blood in the experimental group were higher than those in the control group (1272.74 鹵41.41 鹵21.84 鹵0.94), which were significantly higher than those in the control group (1130.38 鹵122.16 鹵18.32 鹵0.87) (P < 0.05). 3The expression of TLR2 in the chorionic villi of the experimental group was 70.06 鹵30.39, which was significantly higher than that in the control group (54.53 鹵20.00, P < 0.05). 4. The expression of IL-6 TNF- 偽 in serum was positively correlated with the expression of TLR2 in chorionic villi (P < 0.05). There was no correlation between the expression of IL-6 TNF- 偽 and the expression of TLR2 in chorionic villi in the control group (P > 0. 05 P > 0. 013 P > 0. 05). Conclusion The increase of TLR2 expression in chorionic trophoblastic cells was closely related to the increase of TNF- 偽 and IL-6 expression in peripheral blood.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.2

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