主动免疫治疗原因不明习惯性流产的临床研究

目的:探讨主动免疫治疗原因不明习惯性流产(UHA)患者的效果。方法:2001年2月至2005年10月在我院就诊的UHA患者223例作为研究对象。取其丈夫外周静脉血20 ml,分离淋巴细胞后于孕前、孕后注射于患者前臂,使之产生主动免疫。随访其妊娠结局。结果:共妊娠196例(87.9%),其中足月分娩150例(67.3%);目前尚在妊娠中23例(10.3%);再次自然流产23例(10.3%);未受孕27例(12.1%)。年龄33~38岁者流产率明显高于32岁以下者(P<0.05);孕后免疫治疗2~3次者比孕后未治疗或仅治疗1次者有较高的足月分娩率(P<0.05),且孕后治疗1次者流产率明显升高(P<0.05)。结论:主动免疫治疗UHA的疗效肯定,治疗后妊娠成功率高。对于年龄33岁以上患者建议早期保胎治疗;免疫治疗后3个月内受孕,孕后再治疗2次或2次以上较为理想。

Clinical Study of Active Immunotherapy in the Treatment of Unexplained Habitual Abortion

Objective:To investigate the effect of active immunotherapy on unexplained habitual abortion(UHA).Methods:223 cases of UHA were taken into the study.Lymphocytes separated from the peripheral blood of their spouses were injected into their forearms to induce active immunization.Pregnancy outcomes were assessed.Results:Among the 223 cases,196 cases were conceived(87.9%),and 150 cases(67.3%) delivered full-termly,23 cases(10.3%) underwent spontaneous abortion once again,23 cases(10.3%) were still in the process of pregnancy,and 27 cases(12.1%) were infertile.The abortion rate was significantly higher(P<0.05) if the age of the patient exceeded 33 years,and if the patient received only one time immunotherapy after conception.The rate of full-term delivery was lower(P<0.05) in the patients who received no or only one time immunotherapy after conception.Conclusions: Active immunization can improve the pregnancy maintenance in UHA patients.Managements to support pregnancy are preferred to those whose ages surpass 33 years.At least twice immunotherapies are recommended after conception.