付锦华大夫,江湖上被称为保胎界的“战狼”,姐妹们亲切地称她为付奶奶。对妇产科常见病、多发病的诊治有丰富的临床经验及诊治技巧,对本专业疑难、危重及少见病症能正确及时地处理。擅长习惯性流产(复发性流产)、反复胚胎移植失败、原因不明性及生殖免疫性不孕不育、早产。妊高症(子痫前期)、妊娠合并高血压、甲状腺疾病、慢性肾炎、风湿病、糖尿病等相关疾病。许多姐妹在她的保驾护航下,收获了健康的宝贝儿。
近日,付锦华生殖免疫之家公众号上发布了一篇名为「他克莫司可改善反复移植失败患者的生殖结局」的文章,首次在国内公开平台上肯定了他克莫司的作用。而他克莫司的作用正是由杉山产妇人科新宿院的院长中川浩次先生在世界上首次提出的概念。中川院长毕业于自治医科大学,医生博士,日本产科妇人科学会专家,日本生殖医学会生殖医疗专家,获有日本产科妇人科内视镜学会技术认证。文章引用了中川院长发布的英文论文选段。部分摘要如下:
引自:Nakagawa K, Kwak-Kim J, Ota K, Kuroda K, Hisano M, Sugiyama R.Immunosuppression with tacrolimus improved reproductive outcome of women with repeated implantationfailure and elevated peripheral blood TH1/TH2 cell ratios. Am J Reprod Immunol. 2015 Apr;73(4):353-61.
论文原文如下:
Problem:We evaluated the clinical efficacy of immunosuppressive treatment with tacrolimus for repeated implantation failure (RIF) patients who have elevated in T helper (Th1)/Th2 cytokine producing cell ratios.
Method of study:This was a prospective cohort study of treatment for RIF patients (n = 42) with elevated peripheral bloodTh1 (CD4+/IFN-c+)/Th2(CD4+/IL-4+) cell ratios at the Sugiyamaclinic between November 2011 and October 2013. Twenty-five patients were treated with tacrolimus (treatment group) and 17 received no treatment (control group). Treatment group received tacrolimus 2 days before embryo transfer and continued until the day of the pregnancy test, for a total of 16 days. The daily dose of tacrolimus (1–3 mg) was determined based on the degree ofthe Th1/Th2 cell ratio.
Results:The clinical pregnancy rate of the treatment group was 64.0%, which was significantly higher than that of the control group (0%)(P < 0.0001). In the treatment group,the miscarriage rate was 6.3%,the live birthrate was 60.0% (P < 0.0001). There was no significant side-effect from tacrolimus in treatment group. No one developed obstetrical complications during pregnancy.
Conclusion:An immunosuppressive treatment using tacrolimus improved pregnancy outcome of repeated implantation failure patients with elevated Th1/Th2 ratios.
有关于他克莫司更加详细的内容,如需,还有另一篇文章可以参考,链接如下:
https://mp.weixin.qq.com/s/DvfX7T3-UZAQDwxM8skTOQ
中川院长在获知论文被中国国内保胎界“战狼”引用,研究成果被认可后,表示十分高兴。并笑称,那自己就是日本保胎界“战虎”。这样一次大神间的跨国隔空互动,有严肃的一面,也有逗趣的一面。
疾病的复杂性远远超出了现代医学的认知范围,宇宙浩广,真理深邃,我们所知不过浅表。但如果孜孜不倦,别出心裁,另辟蹊径,或许就能探索到尚未知的知识。无论是日本的专家,还是中国的专家,都在繁忙的工作中,在专业领域不知懈怠地进行各项研究,攻克各类医学难题,他们都是非常有医德的大神,也是我们患者的福音。中川院长表示,将来如果有机会,希望能够和付锦华大夫面对面交流专业医学知识,让我们共同期待这一天能够早日到来。