课件：复发性流产.ppt

* 在了解了致流产转变后，就容易理解利于胚胎保护的机制，即与胚胎排斥相反 的机制。 胚胎保护免疫调节有以下三条途径： 不对称抗体：不能与抗原完美结合，仅封闭抗原结构，不激活实体级联反应，无细胞毒及细胞吞噬作用。 保护性或 Th2反应占优势导致保护性细胞因子的激活，抑制有害的Th1 反应。 无 TNF? 和白介素 2释放，因此NK细胞激活减少， NK 细胞不能转变成对 胚胎有毒性的LAK 细胞。 这些因素最终形成保护性免。 * * * * * * This slide shows the chemical structures of progesterone and Duphaston? (dydrogesterone), and illustrates the presence of a second double bond between C6 and C7 in the Duphaston? molecule. It should be noted that the carboxyl groups at position C10 and the Hydrogen molecule at position C9 extend on opposite sides of the molecule in Duphaston? in comparison to progesterone. This leads to Duphaston? have a bent shape. * This slide shows the three-dimensional structure of dydrogesterone (Duphaston?). This “bent” shape leads to Duphaston? being well absorbed and having a predictable bio-availability. It is a highly selective progestogen with excellent tolerability. 这张幻灯片显示地屈孕酮(达芙通)的三维结构.这种‘弯曲’的构型使达芙通极易吸收且有可预测的生物利用度.它是一种高选择性的孕激素并具有卓越的耐受性. Some of the pharmacologic properties include 药理学特征包括 Orally active – well absorbed口服生效-极易吸收 No androgenic, estrogenic or corticoid activity无雄激素,雌激素或肾上腺皮质醇效应 Pure progestogenic action 单纯的孕激素效应 Excellent cycle control卓越的调经效果 No effect on ovulation不影响排卵 Does not induce drowsiness不导致嗜睡 * 达芙通? 通过使子宫内膜从增生期向分泌期转化而有助于利于妊娠子宫内膜的发生。 * 我们已经知道了孕激素的作用，尤其是达芙通? (地屈孕酮) 对黄体功能不全的治疗。新的研究延伸至达芙通? 对妊娠的免疫调节作用。 * Having understood the abortogenic shift, it is now easy to understand the mechanisms in favor of embryo protection - exactly the opposite mechanisms to those for embryo rejection. 了解了流产的免疫因素的相互转换，有利于了解胚胎保护机制的优点－－与胚胎排斥完全相反的机制。 Embryo-protective immuno-modulation takes place in 3 ways: The antibodies are asymmetric. As a result, they do not bind perfectly with the antigens, but only block the antigenic structures without subsequent activation of the complement cascade and cytotoxic and phagocytic reactions. The protective or favorable Th2 response dominates, resulting in activation of protective cy