淋巴细胞免疫治疗对不明原因复发性自然流产患者外周血调节性T细胞及妊娠结局的影响

目的 探讨淋巴细胞免疫治疗不明原因复发性自然流产的机制.方法 自2005年9月至2006年4月就诊于中山大学附属第二医院妇产科的107例不明原因复发性自然流产患者采用淋巴细胞免疫治疗,追踪妊娠结局,并采用流式细胞仪检测的方法观察治疗前后患者外周血调节性T细胞的比例及 FOXP3（forkhead box p3）的表达变化.结果 107例患者淋巴细胞免疫治疗后98例成功妊娠,9例妊娠后在孕早期再次流产,妊娠成功率为91.6%.妊娠成功患者治疗后外周血CD4＋CD25high T细胞及FOXP3的表达显著高于妊娠失败患者（P〈0.05）.结论 淋巴细胞免疫治疗不明原因复发性自然流产患者有较高妊娠成功率,治疗后外周血免疫调节性T细胞尤其CD4＋CD25high T细胞的比例及FOXP3表达升高是患者妊娠成功的关键.

Effect of lymphocyte immunotherapy on pregnancy outcome and peripheral regulatory T cells of the patients with unexplained recurrent spontaneous abortion

Objective： To explore the mechanism of lymphocyte immunotherapy （LIT） in the treatment of unexplained recurrent spontaneous abortion （URSA）. Methods： One hundred and seven patients with URSA who were admitted to the Second Affiliated Hospital of Sun Yat-sen University from September 2005 to April 2006 were studied. All URSA patients were treated with LIT. Pregnancy outcomes were recorded, and the changes of regulatory T cells and forkhead box p3 （FOXP3） expression in peripheral blood were examined by flow cytometry before and after LIT. Results： Ninety-eight of 107 URSA patients succeeded to continue pregnancy after LIT, but nine patients suffered abortion again during the first trimester, which calculated the successful pregnancy rate of 91.6%. The proportion of CD4 ＋CD25 high T cells and FOXP3 expression increased significantly in those successfully continuing pregnancy after LIT when compared with those of patients with pregnancy failure （P〈0. 05）. Conclusions： Treatment of I.IT for URSA patients could much improve pregnancy outcomes, and the increase in the proportion of CD4＋CD25 high T cells and FOXP3 expression may favor the maintenance of pregnancy.