泼尼松改善外周血NK细胞水平升高的不明原因反复种植失败患者妊娠结局的疗效分析

doi:10.11958/20252196

天津医药 ›› 2026, Vol. 54 ›› Issue (2): 122-126.doi: 10.11958/20252196

• 专题研究·生殖系统疾病 • 上一篇下一篇

泼尼松改善外周血NK细胞水平升高的不明原因反复种植失败患者妊娠结局的疗效分析

曾中虹¹^,²^,³(), 磨丹², 杨一华³, 于洋²^,⁴, 李蓉², 马文红¹^,³^,⁵^,^△()

1 南宁市妇幼保健院（邮编530011）
2 北京大学第三医院生殖医学中心
3 广西医科大学第一附属医院广西生殖医学研究中心
4 北京大学第三医院临床干细胞研究中心
5 柳州市妇幼保健院

收稿日期:2025-06-05 修回日期:2025-07-07 出版日期:2026-02-15 发布日期:2026-02-12
通讯作者: 马文红 E-mail:2959298708@qq.com;wenhong_ma@qq.com
作者简介:曾中虹（1998），女，博士在读，主要从事胚胎种植失败方面研究。E-mail:2959298708@qq.com
基金资助:
国家自然科学基金地区基金项目(82360308)

Therapeutic efficacy of prednisone in unexplained recurrent implantation failure patients with elevated peripheral natural killer cells

ZENG Zhonghong¹^,²^,³(), MO Dan², YANG Yihua³, YU Yang²^,⁴, LI Rong², MA Wenhong¹^,³^,⁵^,^△()

1 Nanning Maternity and Child Health Hospital, Nanning 530011, China
2 Center for Reproductive Medicine, Peking University Third Hospital
3 Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University
4 Clinical Stem Cell Research Center, Peking University Third Hospital
5 Liuzhou Maternity and Child Healthcare Hospital

Received:2025-06-05 Revised:2025-07-07 Published:2026-02-15 Online:2026-02-12
Contact: MA Wenhong E-mail:2959298708@qq.com;wenhong_ma@qq.com

曾中虹, 磨丹, 杨一华, 于洋, 李蓉, 马文红. 泼尼松改善外周血NK细胞水平升高的不明原因反复种植失败患者妊娠结局的疗效分析[J]. 天津医药, 2026, 54(2): 122-126.

ZENG Zhonghong, MO Dan, YANG Yihua, YU Yang, LI Rong, MA Wenhong. Therapeutic efficacy of prednisone in unexplained recurrent implantation failure patients with elevated peripheral natural killer cells[J]. Tianjin Medical Journal, 2026, 54(2): 122-126.

摘要/Abstract

摘要：

目的探讨外周血自然杀伤细胞（pNKC）在不明原因反复种植失败（URIF）患者中的临床意义，并评估口服泼尼松对该人群妊娠结局的改善作用。方法回顾性分析373例在广西医科大学第一附属医院和柳州市妇幼保健院接受体外受精/卵母细胞胞浆内单精子注射（IVF/ICSI）治疗的URIF患者。根据pNKC占外周血淋巴细胞的比例将患者分为正常pNKC（<18%）组202例与高pNKC（≥18%）组171例；根据是否服用泼尼松分为泼尼松组211例（包括高pNKC 123例，正常pNKC 88例）和对照组162例（包括高pNKC 48例，正常pNKC 114例）。分析pNKC的大小是否与胚胎着床有关，以及泼尼松对URIF患者妊娠结局的影响。结果正常pNKC组和高pNKC组相比，2组的活产率、临床妊娠率及流产率的差异均无统计学意义（P>0.05）。在pNKC水平正常的URIF患者中，对照组和泼尼松组的妊娠结局差异无统计学意义（P>0.05）。而在高pNKC水平的URIF患者中，泼尼松组的临床妊娠率高于对照组（P<0.05），2组活产率和流产率的差异无统计学意义（P>0.05）。结论 URIF的女性表现出相当高的pNKC计数比例，pNKC水平对URIF患者的妊娠结局无显著影响，对于高pNKC的URIF患者口服泼尼松有潜在益处。

关键词: 杀伤细胞，天然, 胚胎移植, 泼尼松, 妊娠结局, 不明原因反复种植失败

Abstract:

Objective To investigate the clinical significance of peripheral blood natural killer cells (pNKC) in women with unexplained recurrent implantation failure (URIF) and to evaluate the effect of oral prednisone on pregnancy outcomes in this population. Methods A retrospective analysis was conducted on 373 URIF patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment at two tertiary hospitals. Patients were divided into two groups based on the proportion of pNKC in peripheral blood lymphocytes: the normal pNKC group (<18%, 202 cases) and the high pNKC group (≥18%, 171 cases). Patients were categorized by prednisone use: the prednisone group of 211 cases (including 123 cases of high pNKC and 88 cases of normal pNKC) and the control group of 162 cases (including 48 cases of high pNKC and 114 cases of normal pNKC). Whether pNKC concentration was associated with embryo implantation was analyzed. Whether prednisone administration positively affected pregnancy outcomes in URIF patients was also analyzed. Results Compared with the normal pNKC group, there were no significant differences in live birth rate, clinical pregnancy rate or miscarriage rate in the high pNKC group (P > 0.05). In URIF patients with normal pNKC levels, no significant difference was observed in pregnancy outcomes between the control group and the prednisone group (P > 0.05). In URIF patients with high pNKC levels, the clinical pregnancy rate was higher in the prednisone group than that of the control group (P<0.05), but there were no significant differences in live birth rate or miscarriage rate between the two groups (P > 0.05). Conclusion Women with URIF show a relatively high proportion of pNKC counts. The pNKC levels have no significant impact on pregnancy outcome in URIF patients. Oral prednisone may offer potential benefits for URIF patients with high pNKC levels.

Key words: killer cells, natural, embryo transfer, prednisone, pregnancy outcomes, unexplained recurrent implantation failure

中图分类号:

R711.76

图/表 6

参考文献 27

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组别		n		母体年龄/岁		BMI/（kg/m²）			口服泼尼松
正常pNKC组		202		34.85±3.58		22.39±3.09			88（43.6）
高pNKC组		171		34.31±3.84		21.88±2.83			123（71.9）
t或χ²				1.407		1.660			30.328^＊＊
组别			既往胚胎移植次数/次				移植周期
组别			既往胚胎移植次数/次				新鲜周期			冷冻周期
正常pNKC组			4.22±1.93				47（23.3）			155（76.7）
高pNKC组			3.76±1.19				46（26.9）			125（73.1）
t或χ²			2.828^＊				0.653
组别	胚胎分布							卵裂期胚胎/个			囊胚期胚胎/个
组别	卵裂期胚胎				囊胚期胚胎			卵裂期胚胎/个			囊胚期胚胎/个
正常pNKC组	93（46.0）				109（54.0）			1.76±0.43			1.41±0.49
高pNKC组	73（42.7）				98（57.3）			1.79±0.41			1.36±0.48
t或χ²	0.421							0.550			0.644

组别		n		母体年龄/岁		BMI/（kg/m²）			口服泼尼松
正常pNKC组		202		34.85±3.58		22.39±3.09			88（43.6）
高pNKC组		171		34.31±3.84		21.88±2.83			123（71.9）
t或χ²				1.407		1.660			30.328^＊＊
组别			既往胚胎移植次数/次				移植周期
组别			既往胚胎移植次数/次				新鲜周期			冷冻周期
正常pNKC组			4.22±1.93				47（23.3）			155（76.7）
高pNKC组			3.76±1.19				46（26.9）			125（73.1）
t或χ²			2.828^＊				0.653
组别	胚胎分布							卵裂期胚胎/个			囊胚期胚胎/个
组别	卵裂期胚胎				囊胚期胚胎			卵裂期胚胎/个			囊胚期胚胎/个
正常pNKC组	93（46.0）				109（54.0）			1.76±0.43			1.41±0.49
高pNKC组	73（42.7）				98（57.3）			1.79±0.41			1.36±0.48
t或χ²	0.421							0.550			0.644

组别	n	临床妊娠	活产	流产
正常pNKC组	202	84（41.6）	64（31.7）	19（22.6）
高pNKC组	171	72（42.1）	45（26.3）	26（36.1）
χ²		0.010	1.290	2.935

组别	n	临床妊娠	活产	流产
正常pNKC组	202	84（41.6）	64（31.7）	19（22.6）
高pNKC组	171	72（42.1）	45（26.3）	26（36.1）
χ²		0.010	1.290	2.935

组别	n	临床妊娠	活产	流产
正常pNKC组	114	46（40.4）	32（28.1）	13（28.3）
高pNKC组	48	14（29.2）	8（16.7）	6（42.9）
χ²		1.812	2.362	0.039

泼尼松改善外周血NK细胞水平升高的不明原因反复种植失败患者妊娠结局的疗效分析

Therapeutic efficacy of prednisone in unexplained recurrent implantation failure patients with elevated peripheral natural killer cells

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组别	n	临床妊娠	活产	流产
对照组	162	60（37.0）	40（24.7）	19（31.7）
泼尼松组	211	96（45.5）	69（32.7）	26（27.1）
χ²		2.696	2.843	0.030

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