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.

Detection of Blocking Antibody in Patients with Recurrent Spontaneous Abortion and ClinicalEfficacy of Lymphocyte Active Immunotherapy

[Objective]To understand the level of blocking antibody（BA） in patients with recurrent sponta- neous abortion（RSA）, and observe the clinical efficacy of lymphocyte active immunotherapy. [Methods]The level of BA in 218 patients with RSA were detected by enzyme linked immunosorbent assay. Among all pa- tients, 198 patients with BA-negative received lymphocyte active immunotherapy. After the treatment, the level of BA was reexamined. Pregnancy outcomes were traced after the positive conversion of BA. Clinical effi- cacy of immunotherapy was evaluated. [Results]The negative rate of BA in 218 patients with RSA was 90.8~/6o （198/218）. After one course of lymphocyte active immunotherapy, the positive rate of 198 patients with gA- negative was 61.1%. After two courses of therapy, the positive rate was 78.30/60. After three courses of ther- apy, the positive rate was 86.40/00. There was significant difference in the positive rate of BA between before and after treatment（ P d0.05）. Among 198 patients receiving immunotherapy, 164 patients were pregnant a- gain in which 138 patients were successfully pregnant and 26 patients had the recurrence of early spontaneous abortion. The successful rate of pregnancy was 84.2~, and there was significant difference between before and after treatment（ P d0.05）. [Conclusion]The negative rate of BA in patients with RSA is high. Lympho- cyte active immunotherapy can improve the positive rate of BA in patients with RSA. Lymphocyte active im- munotherapy is a safe and effective method for the treatment of RSA caused by the lack of BA.