地屈孕酮與妊娠維持郁琦

1、反復(fù)流產(chǎn)的病因反復(fù)流產(chǎn)的病因Raghupathy R. Seminars in Immunology 2001; 13: 219-227.SPONTANEOUS RECURRENT ABORTIONCauses: Explainable (50-60%)geneticinfectiousendocrineautoimmunologic SLE, Anticardiolipin Abs Unexplained (40-50%)allogenic immuneresponse towards paternal antigensR. Raghupathy (1999)Trop I and Levin

2、e D., AJR 2001;176:607615排斥的免疫途徑排斥的免疫途徑Th1 : T輔助細(xì)胞1型NK : 自然殺傷細(xì)胞抗體（抗體（AB）介導(dǎo)的胚胎毀損或保護(hù)介導(dǎo)的胚胎毀損或保護(hù)胚胎毒性ABsFabFc封閉封閉ABs(隱匿胚胎抗原)導(dǎo)致流產(chǎn)導(dǎo)致流產(chǎn)胚胎保護(hù)胚胎保護(hù)Th1細(xì)胞細(xì)胞介導(dǎo)的胚胎毀損介導(dǎo)的胚胎毀損Th2Th1IL-1IFNTNFIL-10IL-4Dimitrie PO., Gynecological Endocrinology, October 2007; 23(S1): 7781血管內(nèi)凝血蛻膜血管離斷絨毛膜下出血流產(chǎn)NK細(xì)胞細(xì)胞介導(dǎo)的胚胎毀損介導(dǎo)的胚胎毀損導(dǎo)致流產(chǎn)導(dǎo)致流產(chǎn)胚胎胚

3、胎保護(hù)性免疫調(diào)節(jié)保護(hù)性免疫調(diào)節(jié)妊娠妊娠期淋巴細(xì)胞表面上的期淋巴細(xì)胞表面上的P-受體受體Szekeres-Barth J. Int Immunopharm 2001; 1:1037.V 1CD56+激活激活V 1CD56+P PP P+(34 kDa蛋白質(zhì))達(dá)芙通達(dá)芙通的的PIBF誘導(dǎo)作用誘導(dǎo)作用Szekeres-Barth J. Gynecological Endocrinology 2001; 15 (S5): 43.PROMISPROMISPROMIS 研究研究研究研究研究研究達(dá)芙通達(dá)芙通 -胚胎存活的關(guān)鍵胚胎存活的關(guān)鍵Szekeres-Barth J. Gynecological End

4、ocrinology 2001; 15 (S5): 43.Arck P. 22nd Annual Meeting of the American Society of Reproductive Immunology, 2002.Arck P. 22nd Annual Meeting of the American Society of Reproductive Immunology, 2002.Amato NA et al. Minerva Ginecol. 2007;59(4):357-67Mamamtavrishvili I et al. International J Gyn & Obs 2000;70(2):105-105(1)血管一氧化氮分子Simoncini T et al. Fertil & Steril 2006;86(3):1235-42DHD 增加人臍靜脈內(nèi)皮細(xì)胞增加人臍靜脈內(nèi)皮細(xì)胞NO合成合成Simoncini T et al. Fertil & Steril 2006;86(3):1235-42濃度依賴(lài)時(shí)間依賴(lài)363636.236.336.336.436.436.536.536.636.636.736.736.836.836.