反复自然流产患者主动免疫治疗前后封闭抗体变化对再次妊娠的影响研究

目的研究反复自然流产（RSA）患者应用淋巴细胞主动免疫治疗的临床疗效以及治疗前后封闭抗体（BA）变化及对再次妊娠的影响。方法采用酶联免疫法（ELISA）对860例RSA患者的BA进行测定，选择其中820例BA阴性者作为研究对象，采取淋巴细胞主动免疫治疗，2疗程结束后测定BA的变化情况及再次妊娠的结果。结果860例RSA患者主动免疫治疗前BA阳性率仅为4．65％（40／860），820例BA阴性患者经主动免疫治疗一疗程后复查，BA阳性率为75．24％（617／820），2个疗程后复查BA阳性率为86．59％（710／820），与治疗前比较差异有高度统计学意义（P〈0．01）；免疫治疗后，再次妊娠成功率为94．13％（705／749），其中BA阳性者再次妊娠成功率为95．23％（698／733），BA阴性者再次妊娠成功率为43．75％（7／16），BA阳性者再次妊娠成功率显著高于阴性者（P〈0．01）。结论淋巴细胞主动免疫治疗反复自然流产患者能提高BA阳性率及再次妊娠成功率，对反复自然流产患者再次妊娠及提高再次妊娠成功率有很好的指导价值。

Influence of blocking antibody change after active immunotherapy on repregnancy of patients with recurrent spontaneous abortion

Objective To study the clinical efficacy of active lymphocyte immunotherapy for patients with recurrent spontaneous abortion （RSA） and the influence of blocking antibody （BA） change after active immunotherapy on the re- pregnancy of patients with recurrent spontaneous abortion. Methods The enzyme-linked immunosorbent assay （ELISA） was used to measure the BA of 860 RSA patients, of which 820 patients with negative BA were selected as the study object and received active lymphocyte immunotherapy. The BA change and re-pregnancy resuhs were measured after 2 treatment courses. Results The BA positive rate was only 4.65% （40/860） for the 860 RSA patients before active immunotherapy, 75.24% （617/820） for the 820 RSA patients with negative BA after one treatment course of active im- munotherapy and 86.59% （710/820） for the 820 RSA patients with negative BA after 2 treatment courses of active im- munotherapy, with statistically significant differences to that before the treatment （P 〈 0.01）. After the immunotherapy, the re-pregnancy success rate was 94.13% （705/749）, of which the re-pregnancy success rate of patients with positive BA was 95.23% （698/733） and the re-pregnancy success rate of patients with negative BA was 43.75% （7/16）, with the former significantly higher than the latter （P 〈 0.01）. Conclusion Active lymphocyte immunotherapy can improve the BA positive rate and the re-pregnancy success rate in the treatment of patients with recurrent spontaneous abortion and it is of good guidance value to promote the re-pregnancy and the re-pregnancy success rate of patients with recur- rent spontaneous abortion.