淋巴细胞主动免疫治疗原因不明复发性流产后HLA-DR抗体检测及意义

目的探讨淋巴细胞主动免疫治疗原因不明的反复自然流产后患者免疫功能变化及其对妊娠结局的影响。方法选取确诊为原因不明的复发性流产患者350例,应用自身对照法,采用配偶或第三方个体淋巴细胞主动免疫治疗,检测和记录免疫治疗前后患者封闭抗体(HLA-DR抗体)的变化及妊娠成功率。结果符合入组条件321例,经淋巴细胞主动免疫治疗1个疗程后,封闭抗体转为阳性195例(60.75%),2个疗程后累计转为阳性315例(98.13%);封闭抗体转为阳性患者中309例(98.09%)妊娠成功,6例封闭抗体持续阴性者仅3例妊娠成功。结论淋巴细胞主动免疫治疗可有效提高原因不明复发性流产患者妊娠成功率;封闭抗体检测对评估原因不明复发性流产有一定价值。     

主动免疫疗法在原因不明习惯性流产患者中的应用

目的探讨细胞免疫功能的变化与原因不明习惯性流产（UHA）的发生及主动免疫治疗机制的关系。方法用流式细胞仪测定并比较66例UHA患者和30例健康已生育妇女（NF组）及30例主动免疫治疗后的UHA患者外周血CD3^＋、CD4^＋、CD8^＋、CD16^＋CD56^＋细胞亚群百分率及CD4^＋／CD8^＋的比值;同时,比较采用主动免疫治疗30例和未采用主动免疫治疗的36例UHA患者再次妊娠成功率。结果UHA患者与NF组比较,血中CD3^＋、CD16^＋CD56^＋细胞的百分率及CD4^＋／CD8^＋比值增高,差异有统计学意义（P〈0．050）。主动免疫后CD3^＋、CD16^＋CD56^＋细胞的百分率及CD4^＋／CD8^＋比值下降（P〈0．050）。主动免疫治疗组的再次妊娠成功率为92．86％,未主动免疫治疗组29．03％,P〈0．001。结论淋巴细胞亚群比例的改变与UHA的发生有关,主动免疫治疗可调节异常的细胞免疫功能,有利于再次妊娠成功率的提高。     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

主动免疫疗法在原因不明习惯性流产患者中的应用

Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.     

过继妊娠诱导的CD4+CD25+调节性T细胞治疗不明原因复发性流产

目的 观察过继转输正常妊娠诱导的CD4+CD25+调节性T细胞(CD4+CD25+Treg)对不明原因流产的作用机制及妊娠预后的影响.方法 以雌性CBA/J×雄性BALB/c为正常妊娠模型,以雌性CBA/J×雄性DBA/2J为自然流产模型,磁珠分选雌性CBA/J小鼠脾脏CD4+CD25+Treg细胞并流式细胞术(flow cytometry,FCM)分析细胞纯度.将未孕CD4+CD25+Treg细胞和正常妊娠孕14d的CD4+CD25+Treg分别转输至流产模型孕4d(着床期)的雌性CBA/J孕鼠,于孕14d分别观察宿主孕鼠的胚胎吸收率并测定宿主外周血和母胎界面组织体外培养上清液中Th1Th2/Th3型细胞因子(IFN-γ/TGF-βI/IL-10)水平.结果 与对照组比较,过继转输正常妊娠诱导的CD4+CD25+Treg细胞的宿丰孕鼠的胚胎吸收率(11.32%)显著下降;外周血TGF-β 1/IFN-γ中位数(438)和IL-10/IFN-γ中位数(14)显著增加;母胎界而上TGF-β 1中位数(5899.02pg/mL)和IL-10中位数(158.85pg/mL)显著增加,IFN-γ中位数(18.46 pg/mL)显著下降.结论 孕早期过继转输正常妊娠诱导的CD4+CD25+Treg细胞疗法能诱导宿主母胎免疫耐受并调节细胞因子表达,有利于妊娠维持的Th2、Th3应答偏移.     

安子合剂治疗先兆流产的临床效果观察

目的探讨中药安子合剂治疗先兆流产的临床效果。方法将105例先兆流产患者随机分为中药组(52例)和对照组(53例),中药组予安子合剂口服,对照组予黄体酮20 mg/d肌内注射治疗,治疗10 d后比较两组的治疗效果。结果两组治疗后的各症状(阴道出血、腰酸胀痛、小腹疼痛或坠胀、夜尿频繁)评分均较治疗前降低,差异有统计学意义(P0.01),且中药组治疗后各症状评分均低于对照组,差异有统计学意义(P0.05);中药组治疗后的临床效果优于对照组,差异有统计学意义(Z=-2.200,P=0.028)。治疗后两组均未出现明显的不良反应。结论中药安子合剂治疗先兆流产效果显著,且无明显不良反应。     

中医综合疗法用于胸腰椎压缩性骨折的疗效观察

目的分析中医综合疗法用于胸腰椎压缩性骨折的疗效。方法回顾性分析96例胸腰椎压缩性骨折患者的临床资料,其中43例患者采取常规治疗,作为对照组;另外53例患者在常规治疗的基础上,采取中医综合疗法治疗,作为观察组,以内服中药、外敷中药、针刺治疗、穴位注射为主;对比两组患者治疗前后的视觉模拟评分法(VAS)评分、Cobb's角、椎体压缩程度、椎管占位,根据中医病证诊断疗效标准,综合评价患者的疗效,并作对比分析。结果治疗后,观察组患者的VAS评分、Cobb's角、椎体压缩程度、椎管占位均较治疗前明显下降,且与对照组对比,差异具有统计学意义(P0.05);观察组临床总有效率为92.45%,大于对照组的74.42%,经χ2检验,差异具有统计学意义(P0.05)。结论中医综合疗法用于胸腰椎压缩性骨折的疗效确切,结合常规治疗,可进一步重建脊柱的稳定性、恢复伤椎活动功能及改善预后,值得临床推广使用。     

环孢素联合低分子量肝素钙及寿胎丸加减治疗原因不明复发性流产可行性分析

目的:观察环孢素联合低分子量肝素钙及寿胎丸加减治疗原因不明复发性流产的临床疗效.方法:将2017年2月～2019年7月收治的60例原因不明复发性流产患者分为治疗组、对照组各30例,治疗组采用环孢素联合低分子量肝素钙及寿胎丸加减治疗,对照组采用低分子量肝素钙联合寿胎丸加减治疗,两组疗程均为发现怀孕起至孕12周.观察比较两...     

中西医结合治疗急性盆腔炎

目的 :观察抗生素配合中药龙黄解毒汤灌肠治疗急性盆腔炎的临床疗效。方法 :对 96例急性盆腔炎患者随机分成治疗组和对照组各 4 8例 ,用青霉素 4 0 0万单位及甲硝唑 0 .5g静滴 ,2次 /d ,连用 7d ;治疗组于第 4日起加用龙黄解毒方剂浓煎成液灌肠 ,2次 /d。根据辩证治疗原则 ,随症加减用药。对照组于第 4日起加用中成药金刚藤糖浆口服。两组均以 7d为一个疗程 ,1～ 2个疗程结束后评定疗效。结果 :治疗组 1个疗程治愈率 5 8.33% ,2个疗程治愈率 87.5 0 % ;对照组分别为 4 1.6 7%和 5 8.33% ,两组差异有显著性 (P <0 .0 5 )。结论 :抗生素配合龙黄解毒汤灌肠治疗急性盆腔炎疗效明显、经济、安全     

中药灌肠联合美沙拉嗪治疗溃疡性结肠炎Meta分析

目的:系统评价中药灌肠联合美沙拉嗪治疗溃疡性结肠炎的临床疗效及安全性。方法:检索中国知网、万方、维普、中国生物医学数文献据库及PubMed等数据库,检索时间限定为自建库至2019年12月31日,筛选符合纳入标准的随机对照试验(RCTs),应用Cochrane风险偏倚评估工具对纳入文献进行质量学评价,并使用Review manager5.3和stata12.0软件对文献进行Meta分析。结果:共纳入29篇RCT文献,共涉及2 272例患者。Meta分析结果显示,对比单用美沙拉嗪,中药灌肠联合美沙拉嗪有更好的综合疗效[OR=4.90,95%CI=(3.75,6.41),Z=11.59,P0.000 01]和肠镜下黏膜疗效[OR=2.76,95%CI=(1.61,4.73),Z=2.69,P=0.000 2];13篇文献进行了安全性评价,其中3项研究未见明显不良反应,10项研究报道了在治疗期间患者出现胃肠道不良反应、头晕头痛、轻度白细胞下降等轻微不良反应。结论:对比于单用美沙拉嗪,中药灌肠联合美沙拉嗪治疗溃疡性结肠炎有更好的综合疗效和肠镜下黏膜疗效,且安全性较好。但由于文献质量不高,上述结论有待高质量研究进一步验证。     

重症急性胰腺炎的中西医结合治疗

随着对重症急性胰腺炎的发病机制的不断深入研究 ,重症急性胰腺炎的治疗取得了很大进展。我院 1997年 1月～2 0 0 2年 12月共收治了 3 1例重症急性胰腺炎患者 ,采用中西医结合治疗的方法 ,取得了较为满意的效果。现报告如下。1　资料与方法1.1　一般资料　 3 1例患者 ,男 19例 ,女 12例 ,年龄 2 8～ 76岁 ,平均年龄 56.3岁 ,病程 6～ 72h ,平均病程 18.7h ,3 1例患者均符合《急性胰腺炎的临床诊断及分级标准》(1996年中华医学外科学会第 2次会议制订 )中的重症标准。1.2　治疗方法　在禁食 (但不禁中药 )、胃肠减压、镇痛、抗感染、质子泵抑…     

反复自然流产患者封闭抗体检测及淋巴细胞免疫治疗的临床效果

[目的]了解反复自然流产(RSA)患者封闭抗体(BA)的水平,并观察淋巴细胞免疫治疗的临床效果.[方法]用酶联免疫吸附试验测定218例RSA患者BA水平,并对其中198例BA阴性患者进行淋巴细胞免疫治疗,疗程结束后复查BA,追踪BA转阳后妊娠情况,评估免疫治疗的临床效果.[结果]218例RSA患者中BA阴性率为90.8％ (198/218),198例BA阴性患者经淋巴细胞免疫治疗1个疗程后,BA阳性率为61.1％,2个疗程后阳性率为78.3％,3个疗程后阳性率为86.4％,BA阳性率与治疗前比较差异均有显著性(P＜0.05);198例免疫治疗的患者中,有164例再次妊娠,其中138例获妊娠成功,26例再次发生早期自然流产,妊娠成功率为84.2％,与治疗前比较差异具有显著性(P＜0.05).[结论]RSA患者BA阴性率高,用淋巴细胞免疫治疗可提高RSA患者的BA阳性率,淋巴细胞免疫治疗是一种治疗BA不足引起RSA的安全、有效的方法.     

中西医结合孕前孕后并治不明原因早期复发性流产疗效观察

目的:观察中西医结合孕前与孕后联合治疗不明原因早期复发性自然流产的临床疗效。方法:选择符合入选标准的不明原因早期复发性流产患者90例,随机分为研究组48例和对照组42例,研究组自计划妊娠的前3个月开始接受补肾健脾中药治疗至孕3个月止,对照组孕后开始接受同样的中药治疗至孕12周;两组自孕前3个月至孕12周期间都同时服用天然维生素E胶丸和叶酸片,孕后两组都接受黄体酮安胎治疗。随访至孕28周,比较妊娠结局。结果:研究组临床妊娠成功率显著高于对照组(P<0.05)。结论:中西医结合孕前孕后并治不明原因早期复发性流产疗效显著优于孕后开始接受治疗者。     

身痛逐瘀汤加减配合中医定向透药疗法治疗腰椎间盘突出症的临床观察

目的探讨腰椎间盘突出症采用身痛逐瘀汤加减配合中医定向透药疗法治疗的疗效。方法选取60例于2016年5月~2017年1月我院接收的腰椎间盘突出症患者,随机分为对照组(常规保守治疗,n=30)与试验组(常规治疗+身痛逐瘀汤加减配合中医定向透药疗法,n=30),观察两组疗效。结果试验组患者较对照组临床有效率显著要高(P0.05);治疗后1个月、3个月、半年、12个月时,两组VAS评分较治疗前均显著下降,而试验组下降幅度更为显著(P0.05);治疗后1个月、3个月、半年、12个月时,两组JOA评分均显著升高,而试验组升高幅度更为显著(P0.05)。结论腰椎间盘突出症采用身痛逐瘀汤汤剂与中医定向透药疗法联合治疗可取得显著疗效,具有推广价值。