主动免疫联合HCG治疗复发性流产的临床疗效

目的对主动免疫联合人绒毛膜促性腺激素(HCG)治疗复发性流产的临床疗效进行综合评价。方法从2007年7月至2012年12月期间就诊的不明原因反复自然流产(URSA)患者中选取170例,所有患者分为三组,分别采用主动免疫联合HCG法、主动免疫法及HCG法对复发性流产患者进行治疗。对不同疗法的治疗效果进行评价分析。结果主动免疫联合HCG组治愈成功率为76.6%(49/64),采用主动免疫治疗组的成功率为67.9%(38/56),采用HCG治疗组成功率为42.0%(21/40)。三组患者的妊娠成功率两两比较均具有显著性差异(P0.05)。采用配偶淋巴细胞主动免疫的成功率大于采用第三方淋巴细胞主动免疫的妊娠成功率。≤30岁组治愈成功率为81.8%(36/44),30~35岁组成功率为79.2%(76/96),≥35岁组成功率为56.7%(17/30)。≤30岁组及30~35岁组患者的妊娠成功率显著大于≥35岁组(P0.05)。结论采用淋巴细胞主动免疫对治疗不明原因复发性流产病有良好的效果,采用主动免疫联合HCG法,能够提高妊娠成功率,值得临床推广应用。

Study on clinical effect of active immunization combined with HCG in treatment of patients with recurrent spontaneous abortion

Objective To evaluate the clinical effect of active immunization combined with HCG in treatment of patients with recurrent spontaneous abortion. Methods There were 170 patients with recurrent spontaneous abortion in this hospital during July 2007 to December 2012.They were divided into three groups by therapeutic methods. Patients in group A were treated by the combination of active immunization and administration of HCG,patients in group B were treated with active immunization and patients in group C were treated with administration of HCG.Then,the therapeutic effect of different regimens for treatment had been evaluated. Results The cure rate of patients in group A was 76. 6%（ 49 /64）. The cure rate in patients of group B was 67. 9%（ 38 /56）,and the cure rate in patients with administration of HCG was 42. 0%（ 21 /40）. Diversity analysis showed that the rates of pregnancy in patients of three groups had significant difference（ P〈0. 05）. The successful rate of active immunization with lymphocytes from husband was higher than those using lymphocytes from others for active immunization. The successful rate in patients with 30 years old or less was 81. 8%（ 36 /44）. The successful rate in patients with 30 to 35 years old was 79. 2%（ 76 /96） and that for patients over 35 years old was 56. 7%（ 17 /30）. Variance analysis showed that difference in patients 〈35 years old and ≥35 years old was significant（ P〈0. 05）. Conclusion The curative effect of active immunization combined with administration of HCG in treatment of patients with recurrent spontaneous abortion is good. It should be popularly applied.