| 摘要: |
| ［摘要］ 目的 分析体外受精-胚胎移植（IVF-ET）失败患者子宫内膜CD38和CD138表达特点及其与慢性子宫内膜炎（CE）的关联性。方法 招募2023年4月至2024年9月于常州市妇幼保健院行IVF-ET但未成功妊娠的患者114例。所有患者均接受宫腔镜检查，并获取子宫内膜组织。通过苏木精-伊红（HE）染色进行病理分型。通过免疫组化染色检测CD38和CD138的表达情况，根据检测结果将患者分为CD38+/CD138+组（34例）、CD38+/CD138-组（37例）、CD38-/CD138+组（23例）和CD38-/CD138-组（20例）。分析CD38和CD138的表达情况与CE发生及患者在多西环素治疗后经辅助生殖的妊娠结局的关联性。结果 114例患者中CE发生率为38.60%（44/114），四组CE发生率比较差异有统计学意义（P<0.05），以CD38+/CD138+组发生率最高，为70.59%。四组正常子宫内膜比例差异有统计学意义（P<0.05），以CD38-/CD138-组正常率最高，为55.00%。94例患者接受多西环素治疗，经辅助生殖，妊娠48例（51.06%）。CD38+/CD138+组、CD38+/CD138-组和CD38-/CD138+组的妊娠率分别为35.29%（12/34）、67.57%（25/37）和47.83%（11/23），三组比较差异有统计学意义（χ2=7.513，P=0.023），CD38+/CD138+组妊娠率显著低于CD38+/CD138-组（χ2=7.395，P=0.007）。多因素logistic回归分析结果显示，CD38+/CD138+是患者接受多西环素治疗后妊娠失败的独立危险因素［OR（95%CI）=3.749（1.093～12.862），P=0.036］。结论 CD38、CD138表达情况与IVF-ET种植失败患者CE发生相关，并对多西环素治疗效果产生影响，据此开展个体化治疗策略可能有助于改善患者妊娠结局。 |
| 关键词: 慢性子宫内膜炎 CD38 CD138 体外受精-胚胎移植 多西环素 妊娠 |
| DOI：10.3969/j.issn.1674-3806.2025.11.14 |
| 分类号: |
| 基金项目:江苏省卫生健康委2023年度医学重点科研项目（编号：K2023058）；江苏省妇幼保健协会科研课题项目（编号：FYX202323）；常州市“十四五”卫生健康拔尖人才培养工程（编号：2022CZBJ086）；常州市科技计划项目（编号：CJ20246011） |
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| Analysis on expression characteristics of CD38 and CD138 in endometria of patients with failed in vitro fertilization-embryo transfer and their associations with chronic endometritis |
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MIAO Jun1, XUE Pingping1, ZHU Li2, Baktnur Kenjekul3, ZHUANG Jing1
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1.Department of Gynecology, Changzhou Medical Center, Nanjing Medical University, Changzhou Maternal and Child Health Care Hospital, Changzhou 213000, China; 2.Department of Emergency, the First People′s Hospital of Changzhou(the Third Affiliated Hospital of Soochow University), Changzhou 213003, China; 3.Department of Obstetrics and Gynecology, the People′s Hospital of Wuqia County, Kizilsu Kirgiz Autonomous Prefecture 845450, China
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| Abstract: |
| ［Abstract］ Objective To analyze the expression characteristics of CD38 and CD138 in endometria of patients with failed in vitro fertilization-embryo transfer(IVF-ET) and their correlations with chronic endometritis(CE). Methods A total of 114 patients who underwent IVF-ET but failed to conceive in Changzhou Maternal and Child Health Care Hospital from April 2023 to September 2024 were recruited. All the patients underwent hysteroscopy and their endometrial tissues were obtained. The endometrial tissues of the patients were stained by using hematoxylin-eosin(HE) and the pathological typing was performed. The expressions of CD38 and CD138 were detected by using immunohistochemical staining, and according to the detection results the patients were divided into CD38+/CD138+ group(34 cases), CD38+/CD138- group(37 cases), CD38-/CD138+ group(23 cases) and CD38-/CD138- group(20 cases). The associations of the expressions of CD38 and CD138 with the occurrence of CE as well as the pregnancy outcomes of the patients who received assisted reproduction after doxycycline treatment were analyzed. Results In the 114 patients, the incidence of CE was 38.60%(44/114). There was a statistically significant difference in the incidence of CE among the four groups(P<0.05), with the highest incidence of CE in the CD38+/CD138+ group(70.59%). The difference in the proportion of normal endometria was statistically significant among the four groups(P<0.05), with the highest normal rate(55.00%) in the CD38-/CD138- group. Among the 94 patients treated with doxycycline, 48 patients(51.06%) became pregnant after assisted reproduction. The pregnancy rates of the CD38+/CD138+ group, the CD38+/CD138- group and the CD38-/CD138+ group were 35.29%(12/34), 67.57%(25/37) and 47.83%(11/23), respectively. There was a statistically significant difference in the pregnancy rate among the three groups(χ2=7.513, P=0.023), and the pregnancy rate of the CD38+/CD138+ group was significantly lower than that of the CD38+/CD138- group(χ2=7.395, P=0.007). The results of multivariate logistic regression analysis showed that CD38+/CD138+ was an independent risk factor for pregnancy failure in patients after they received doxycycline treatment［OR(95%CI)=3.749(1.093-12.862), P=0.036］. Conclusion The expressions of CD38 and CD138 are related to the occurrence of CE in patients with failed IVF-ET implantation and have impacts on the therapeutic effect of doxycycline. The individualized treatment strategies carried out on the basis of these results may help to improve the pregnancy outcomes of the patients. |
| Key words: Chronic endometritis(CE) CD38 CD138 In vitro fertilization-embryo transfer(IVF-ET) Doxycycline Pregnancy |
