复发性流产患者Th1/Th2细胞因子失衡及淋巴细胞主动免疫治疗的疗效

目的:探讨不明原因反复流产(URSA)患者Th1/Th2细胞因子失衡关系及淋巴细胞主动免疫治疗的疗效。方法:采用细胞因子体外诱生技术对72例URSA患者和30例正常妇女的外周血单个核细胞进行诱生培养68h后,采用双抗体夹心酶联免疫吸附法检测上清液中的Th1(IFN-γ)和Th2(IL-4)细胞因子水平;URSA患者分为淋巴细胞主动免疫治疗组和常规HCG保胎组,前瞻性研究淋巴细胞主动免疫治疗前后IFN-γ、IL-4细胞因子变化及两组的妊娠结局。结果:URSA患者IL-4水平低于正常对照组(P<0.05),Th1/Th2比值偏向Th1。经主动免疫治疗后,URSA患者IFN-γ水平降低(P<0.05),IL-4水平升高(P<0.05),Th1/Th2比值降低,偏向Th2(P<0.05)。主动免疫妊娠成功率达到85.71%。结论:URSA的发生可能与Th1/Th2平衡失调有关,主动免疫治疗可以有效纠正Th1/Th2平衡失调,对URSA患者是一种有效的治疗方法。

Imbalance of Th1/Th2 cytokines in patients with recurrent abortion and curative effect of active immunotherapy of lymphocytes

Objective:To explore the imbalance of Th1/Th2 cytokines in patients with unexplained recurrent spontaneous abortion(URSA) and curative effect of active immunotherapy of lymphocytes.Methods:Mononuclear cells in peripheral blood of 72 patients with URSA and 30 normal women were cultured for 68 hours,double antibody sandwich ELISA was used to detect the levels of interferon-γ(the cytokine of Th1 cells) and interleukin-4(IL-4)(the cytokine of Th2 cells) in liquid supernatant;the patients with URSA were divided into active immunotherapy group and routine human chorionic gonadotropin(HCG) therapy group;the changes of interferon-γ and IL-4 levels before and after active immunotherapy in active immunotherapy group and pregnancy outcomes in the two groups were researched prospectively.Results:IL-4 level in URSA group was statistically significantly lower than that in normal control group(P<0.05).The ratio of Th1/Th2 deviated to Th1.After active immunotherapy,interferon-γ level in URSA group decreased significantly(P<0.05),IL-4 level increased significantly(P<0.05),the ratio of Th1/Th2 decreased and deviated to Th2(P<0.05).The successful rate of pregnancy after active immunotherapy was 85.71%.Conclusion:The occurrence of URSA may be correlated with imbalance of Th1/Th2 cytokines,active immunotherapy can effectively correct imbalance of Th1/Th2,which is an effective method to cure patients with URSA.