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目的探讨低剂量米非司酮对植入窗口期子宫内膜中子宫自然杀伤(uNK)细胞数量及其亚型含量的影响。方法收集正常妇女植入窗口期的子宫内膜14份,将每份内膜组织平均分为3部分,分别用浓度为65 nmol/L 米非司酮(A 组)、200 nmol/L 米非司酮(B 组)和0 nmol/L 米非司酮(对照组)进行体外培养,运用免疫组化和流式细胞技术检测 uNK 细胞数量及 CD_3~-CD_(56)~+CD_(16)~-亚型、CD_3~-CD_(56)~+CD_(16)~+亚型的百分含量。结果 (1)A、B 及对照组子宫内膜中 CD_(56)~+uNK 细胞数量分别为(148±11)、(150±12)和(121±7)个,A、B 组分别与对照组比较,差异均有统计学意义(P<0.05);A、B 组之间比较,差异无统计学意义(P>0.05)。(2)A 组和 B 组子宫内膜中 CD_3~-CD_(56)~+亚型百分含量分别为(44±5)%和(48±4)%,高于对照组[(35±3)%],差异有统计学意义(P<0.05),A、B 组间比较,差异无统计学意义(P>0.05);A 组和 B 组子宫内膜 CD_3~-CD_(56)~+CD_(16)~-亚型百分含量分别为(42±5)%和(45±5)%,高于对照组[(33±3)%],差异有统计学意义(P<0.05),A、B 组间比较,差异无统计学意义(P>0.05);CD_3~-CD_(56)~+CD_(16)~+亚型百分含量分别为(2.70±0.24)%、(3.26±0.37)%和(2.33±0.29)%,3组间比较,差异无统计学意义(P>0.05)。结论低剂量米非司酮可通过增加uNK 细胞数量及 CD_3~-CD_(56)~+CD_(16)~-亚型百分含量,使植入窗口期子宫内膜局部免疫微环境失平衡,从而可能导致胚胎植入的失败。
Objective To investigate the effect of low dose mifepristone on the number of uterine natural killer (uNK) cells and their subtypes in the implantation window. Methods The endometrium of 14 women with normal endometrium was collected. The endometrium of each woman was divided into three groups, which were treated with 65 nmol / L mifepristone (group A), 200 nmol / (B group) and 0 nmol / L mifepristone (control group) were cultured in vitro. Immunohistochemistry and flow cytometry were used to detect the number of uNK cells and the number of CD_3 ~ -CD_ (56) ~ + CD_ (16) ~ - isoforms, the percentage of CD_3 ~ -CD_ (56) ~ + CD_ (16) ~ + isoforms. Results (1) The numbers of CD_ (56) ~ + uNK cells in the endometrium of A, B and control groups were (148 ± 11), (150 ± 12) and (121 ± 7) The difference between the two groups was statistically significant (P <0.05). There was no significant difference between group A and group B (P> 0.05). (2) The percentages of CD_3 ~ -CD_ (56) ~ + subtypes in group A and group B were (44 ± 5)% and (48 ± 4)%, respectively, (P <0.05). There was no significant difference between group A and group B (P> 0.05). In group A and group B, the levels of CD_3 ~ -CD_ (56) ~ (42 ± 5)% and (45 ± 5)%, respectively, higher than that in the control group [(33 ± 3)%], the difference was statistically significant (P <0.05 (P <0.05). The percentages of CD_3 ~ -CD_ (56) ~ + CD_ (16) ~ + subtypes were (2.70 ± 0.24)% and 3.26 ± 0.37)% and (2.33 ± 0.29)%, respectively. There was no significant difference between the three groups (P> 0.05). Conclusions Mifepristone at low dose can decrease the number of uNK cells and the percentages of CD_3 ~ -CD_ (56) ~ + CD_ (16) ~ -subtype, Which may lead to the failure of embryo implantation.