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目的观察采用丈夫或无关第三方外周血淋巴细胞治疗复发性流产的临床疗效,探讨封闭抗体与再次妊娠结局的关系。方法回顾性分析复发性流产且封闭抗体阴性的患者148例,采用淋巴细胞治疗,了解治疗后封闭抗体的变化及再次妊娠结局。结果 148例患者中,115例获妊娠成功,33例再次发生流产,妊娠成功率为77.7%(115/148);主动免疫治疗后118例患者进行复查,其中60例阳性,阳性率为50.8%(60/118),与治疗前比较,差异有统计学意义(P0.05);封闭抗体阳性组、阴性组与未复查组的妊娠成功率分别为81.67%、74.13%、76.66%,差异无统计学意义(P0.05)。结论淋巴细胞主动免疫治疗能提高封闭抗体阴性的复发性流产患者的再次妊娠成功率及封闭抗体的阳性率,是治疗复发性流产的一种有效方法。 相似文献
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目的了解采用淋巴细胞对复发性流产进行主动免疫的疗效。方法采用丈夫外周血淋巴细胞治疗复发性流产,454例患者疗程结束并成功随访,妊娠至20周后者为治愈。结果 116(25.55%)例足月分娩,治愈率70.48%(未包括已孕20周内)。其间1例孕20周诊断无脑儿,1例孕26周超声示胎儿先天性左心发育不良,畸形率0.44%。结论免疫治疗是安全、有效的治疗复发性流产的方法之一,能确实解决病患实际问题。 相似文献
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复发性流产的免疫治疗效果分析 总被引:1,自引:0,他引:1
目的了解采用淋巴细胞对复发性流产进行主动免疫的疗效。方法采用丈夫外周血淋巴细胞治疗复发性流产,454例患者疗程结束并成功随访,妊娠至20周后者为治愈。结果116(25.55%)例足月分娩,治愈率70.48%(未包括已孕20周内)。其间1例孕20周诊断无脑儿,1例孕26周超声示胎儿先天性左心发育不良,畸形率0.44%。结论免疫治疗是安全、有效的治疗复发性流产的方法之一,能确实解决病患实际问题。 相似文献
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目的 探讨本院生殖门诊患者淋巴细胞主动免疫治疗对原因不明性复发性流产不同疗程的疗效.方法 选取本院患者200例,治疗组:提取其丈夫淋巴细胞进行主动免疫,孕前及孕后均4次.对照组:同样进行淋巴细胞主动免疫,孕前4次,孕后只注射1~2次.自孕前免疫治疗4次疗程完成时开始,18个月后对其封闭抗体转阳率、妊娠成功率等进行比较.结果 2组比较对照组封闭抗体转阳率、妊娠成功率均低于治疗组,差异有统计学意义(P<0.05).结论 淋巴细胞提取治疗免疫原因引起的复发性流产,微创,操作简单,安全经济,疗效满意,值得临床推广. 相似文献
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目的 探讨单纯静脉注射免疫球蛋白(IVIG)被动免疫治疗及淋巴细胞主动免疫(LIT)联合静脉注射免疫球蛋白(IVIG)被动免疫治疗对复发性流产患者的治疗效果及对其免疫状态的影响.方法 临床确诊为封闭抗体阴性复发性流产患者124例,随机平均分为两组:A组仅接受IVIG,B组接受LIT及IVIG联合治疗,比较两组患者封闭抗体转阳率,临床妊娠率,患者血清淋巴细胞亚群CD3+、CD4+、CD8+水平、CD4 +/CD8+比率及细胞因子IFN-γ、IL-10水平和NK细胞含量的变化.结果 免疫治疗后,A组封闭抗体转为阳性者45例(72.58%)、B组封闭抗体转为阳性者58例(93.55%),两组之间差异有统计学意义(X2 =9.688,P<0.05);两组成功妊娠率为A组妊娠39例(62.90%),B组妊娠51例(82.26%),两组之间差异有统计学意义(X2 =5.835,P<0.05).接受免疫治疗后B组与A组比较,CD3+细胞百分比较治疗前升高,有统计学意义(t=2.497,P<0.05);CD4+细胞百分比降低(t=4.514,P<0.05);CD8+细胞百分比升高(t=21.697,P<0.05);CD4+/CD8+比率降低(t=2.146,P<0.05),IFN-γ水平降低(t=4.514,P<0.05),IL-10则升高(t=21.697,P<0.05);外周血NK细胞百分比下降(t=2.146,P<0.05),B组变化幅度均高于A组,差异具有统计学意义.结论 封闭抗体阴性复发性流产患者接受免疫治疗能改善体内细胞免疫状态,具有较好的疗效,LIT联合IVIG治疗较单独应用IVIG效果更好. 相似文献
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目的观察主动免疫治疗不明原因复发性流产的疗效。方法对143例不明原因复发性流产患者采取主动免疫治疗,观察其治疗后封闭抗体(BA)和淋巴细胞亚群的变化及再次妊娠的结局。结果 (1)临床妊娠成功112例,再次早期流产5例,26未受孕,妊娠成功率78.3%;(2)主动免疫治疗后复查,115例BA转阳性,阳性率80.4%。阳性率与治疗前比较差异有高度统计学意义(P<0.01)。(3)主动免疫治疗后CD3+细胞无变化,CD4+细胞、CD4+/CD8+比值较治疗前明显下降,CD8+细胞则明显升高(均P<0.01)。结论淋巴细胞主动免疫治疗能提高BA阴性的不明原因复发性流产患者的再次妊娠成功率及提高BA的阳性率,并可调节异常的细胞的免疫功能,有利于再次妊娠成功率的提高。 相似文献
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习惯性流产患者的淋巴细胞免疫治疗 总被引:3,自引:0,他引:3
反复习惯性流产(reeurent or repetitive spontaneous abortion,RSA)是指连续发生了3次或3次以上的自然流产。发生率为0.4%~1.0%,原因复杂,有解剖、内分泌、遗传、感染等原因,其中有40%~80%的患者原因不明,考虑与免疫有关,而封闭抗体(blocking antibody,BA)的缺乏是RSA的重要原因之一。我院自2003年9月始,利用丈夫淋巴细胞皮内注射,治疗原因不明的自然流产44例,治愈率达73.8%。收到良好的效果,现报道如下。 相似文献
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36例封闭抗体不足习惯性流产患者免疫治疗的临床分析 总被引:1,自引:0,他引:1
为了探讨36例封闭抗体不足习惯性流产患者接受淋巴细胞免疫治疗的效果。病例选自2007年1月至2009年12月在三家医院就诊36例封闭抗体阴性习惯性流产患者,进行淋巴细胞免疫治疗。结果显示:36例患者在接受3个疗程的免疫治疗后,封闭抗体转为阳性30例(83.3%),与治疗前比较有统计学意义(P<0.01)。32例再次妊娠,3例再次发生早中期流产,妊娠时间维持到28~32周者共2例,32周~36+6周21例,足月分娩活婴6例,妊娠总成功率为80.6%。结果表明,淋巴细胞免疫是一种治疗封闭抗体不足习惯性流产有效、安全的方法。 相似文献
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目的探讨原因不明性不孕不育患者运用淋巴细胞免疫治疗后的临床疗效。方法对原因不明的复发性流产、不孕患者132例,运用淋巴细胞皮内注射主动免疫治疗。结果 112例复发性流产患者中43例成功妊娠满12周,占38.39%;1例发生例再次发生流产;20例原因不明性不孕患者中4例成功妊娠满12周,占20%。结论淋巴细胞主动免疫治疗原因不明性不孕不育有较可靠的临床效果及应用价值,封闭抗体对妊娠结局及治疗效果有一定的预示价值。 相似文献
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配偶淋巴细胞免疫治疗反复自然流产91例分析 总被引:16,自引:0,他引:16
目的探讨反复自然流产患者,运用配偶淋巴细胞免疫治疗后,体内封闭抗体水平的变化及其临床疗效.方法对确诊为封闭抗体缺乏的RSA患者91例,用分离的配偶淋巴细胞,皮内注射法免疫治疗3~5疗程,治疗前后运用流式细胞仪测定患者体内封闭抗体水平.结果 91例RSA患者经免疫治疗后,体内封闭抗体的水平显著提高,抗配偶CD3%、抗配偶CD4%、抗配偶CD8%,分别由治疗前的-1.32±0.98、-1.39±0.80、-0.96±0.54上升为0.99±0.74、1.01±0.64、0.75±0.49(P<0.05);妊娠成功80例,成功率为87.9%(80 / 91).结论配偶淋巴细胞免疫治疗,可以提高患者体内封闭抗体水平,有助于妊娠成功. 相似文献
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目的比较不明原因反复自然流产主动免疫治疗不同疗程的临床疗效。方法将160例APLA阴性患者分为3组,60例治疗组只治疗一疗程4次后妊娠,78例对照组每3周治疗1次,直至APLA转阳后妊娠;22例未治疗后直接妊娠,观察3组妊娠结局。APLA采用淋巴细胞毒实验进行检测。结果免疫治疗前APLA阳性率为8.57%,免疫治疗后治疗组、对照组APLA阳性率分别为41.67%、94.87%,治疗前后APLA比较差异显著(P〈0.01)。治疗组妊娠成功率为88.64%,对照组妊娠成功率为90.77%,两组比较差异不显著(P〉0.05),未治疗组妊娠成功率为43.75%,与前两组比较差异显著(P〈0.01)。结论免疫治疗能有效刺激母体产生封闭抗体。对不明原因反复自然流产患者孕前进行一疗程4次治疗具有疗程短、疗效显著、妊娠结局好等特点。 相似文献
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I. T. MANYONDA R. S. PEREIRA J. M. PEARCE C. E. M. SHARROCK 《Clinical and experimental immunology》1993,93(1):132-137
Using limiting dilution analysis (LDA) we determined anti-paternal cytotoxic T lymphocyte precursor (CTLp) frequencies in the peripheral blood of 10 women with unexplained recurrent spontaneous abortion (RSA) before and after immunization with paternal lymphocytes. The women and their partners were HLA tissue-typed and none of the women had anti-paternal cytotoxic antibodies (APCA) before immunization. All other known causes of RSA were excluded. All 10 women were found to have high frequencies of specific anti-paternal cytotoxic T cells before immunization (range I 1/1030 to 1/9574). Splitwell analysis showed that these cytotoxic cells were specific to paternal MHC antigens. These frequencies rose significantly following immunization (range 1/683 to 1/4652). The cytotoxic T lymphocyte frequencies against an HLA-mismatched third party varied from woman to woman, but were not affected by the immunization. The LDA data conformed lo single-hit kinetics, indicating that only cytotoxic T ceils were limiting in the assay. Our data are in sharp contrast to the previously held view that women with RSA may be hyporesponsive to paternal MHC antigens. Immunizing such women with paternal leucocytes further sensitizes them. These findings cannot be reconciled with a favourable outcome in the treatment of RSA with immunotherapy. We would argue that this treatment is al best of unproven value, and may even be harmful. Thai these women may sometimes have successful pregnancies following immunotherapy testifies to the effectiveness of the classical MHC antigen-deficient trophoblast as an immunological barrier between mother and fetus. 相似文献
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Epidemiology of recurrent spontaneous abortion. 总被引:20,自引:0,他引:20
With recent scientific advances leading to better understanding of the immunobiology of recurrent spontaneous abortion (RSA), interest has now focused upon the epidemiology of RSA. A cohort of 214 couples with a history of two or more consecutive abortions were studied for the prevalence of etiologic factors and association with other reproductive failures. The prevalence of causes of RSA in this cohort was compared with etiologic factors among 179 couples with a history of three or more consecutive abortions. The obstetrical histories of 214 women with RSA were analyzed for the total number of pregnancies, live births, stillbirths, spontaneous abortions, ectopic pregnancies, and hydatidiform moles. These numbers were compared with the expected frequency of each in the general population. The prevalence of etiologies among 214 with RSA were as follows: chromosomal-6%, anatomic-1%, hormonal-5%, immunologic-65%, and unexplained-23%. No differences in the prevalence of etiologic factors exist when couples with a history of two or more abortions are compared with three or more abortions. When the number of ectopic pregnancies, molar pregnancies, and stillbirths among 214 women with RSA were compared with the expected numbers, the odds ratios were 2.2 for ectopic pregnancies, 6.0 for molar pregnancies, and 2.3 for stillbirths. These data indicate that no difference in the prevalence of etiologies of RSA exist when couples with two or more abortions are compared with three or more and a comorbidity between RSA and other types of reproductive failure exists. 相似文献
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1alpha,25-dihydroxy-vitamin-D3 as new immunotherapy in treatment of recurrent spontaneous abortion 总被引:3,自引:0,他引:3
Bubanovic I 《Medical hypotheses》2004,63(2):250-253