联合主动免疫治疗原因不明习惯性流产疗效分析

目的探讨淋巴细胞主动免疫联合人绒毛膜促性腺激素(hCG)/黄体酮治疗原因不明习惯性流产(UHA)的疗效。方法50例UHA患者采用淋巴细胞行主动免疫治疗,妊娠后分别采用hCG或黄体酮保胎治疗。结果经治疗后50例患者中29例妊娠,其中分娩21例,中晚期妊娠各2例,流产4例,妊娠成功率86%(25/29);主动免疫联合hCG妊娠成功率88%(14/16),联合黄体酮成功率85%(11/13),两者疗效相似;主动免疫治疗后封闭抗体转为阳性3例,其中2例成功妊娠,封闭抗体仍为阴性26例中,成功妊娠23例,二者比较无统计学差异。结论对于UHA患者,淋巴细胞主动免疫联合hCG/黄体酮是一种简单有效的治疗方法,两种联合主动免疫疗法的疗效无显著差异,主动免疫治疗后封闭抗体转阳与否与妊娠结局无相关性。

The effect of combined active immunotherapy on the patients with unexplained habitual abortion

Objective: To investigate the effect of active immunotherapy combined with human chorionic gonadotropin (hCG) or progesterone on the patients with unexplained habitual abortion (UHA). Method: Fifty patients with UHA were treated by active immunotherapy using lymphocytes, combined with hCG or progesterone. Results: Among 29 pregnant women, there were 21 live births, 2 at second trimester, 2 at third trimester, and 4 miscarriages, which calculated a total successful pregnancy rate of 86%. There was no significant difference in the successful pregnancy rate of the patients either combined with hCG (88%) or progesterone (85%). After active immunotherapy, three of 29 pregnant patients had positive blocking- antibody, and two of them obtained successful pregnancy. The successful pregnant rate of the negative patients was 89% (23/26). There was no significant difference in two groups. Conclusions: It is an effective method of active immunotherapy, combined with hCG or progesterone, for the patients of unexplained habitual abortion. There is no significant difference of successful pregnancy in the patients whether combined with hCG or progesterone. The blocking-antibody is not a predictor for successful pregnancy.