淋巴细胞主动免疫治疗不明原因复发性流产89例分析

目的探讨不明原因复发性流产患者采用淋巴细胞主动免疫治疗前后封闭抗体(BA)的变化及疗效,并分析流产次数、患者年龄与妊娠结局的关系。方法对89例BA阴性的不明原因复发性流产患者进行淋巴细胞主动免疫治疗,观察其治疗后BA的变化及妊娠结局。结果 1患者治疗前BA检测均为阴性,接受免疫治疗3次后,BA转阳者36例(40.4%),免疫治疗6次后BA阳性42例(47.2%)。89例反复性流产患者免疫治疗6次后共转阳78例,转阳率为87.6%。与治疗前相比,差异有统计学意义(P<0.05);2在89例治疗的患者中,有79例获妊娠成功,10例再次发生早期流产,妊娠成功率88.76%(79/89),BA阳性患者的妊娠成功率明显高于BA阴性者,差异有统计学意义;3流产次数≤3次者治疗后妊娠成功率明显高于流产次数>3次者(P<0.05);4年龄≤35岁者妊娠成功率明显高于年龄>35岁者(P<0.05)。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,建议连续自然流产2次或以上者及早干预治疗。

Analysis of Lymphocyte Immunotherapy in the Treatment of 89 Unexplained Recurrent Spontaneous Abortion

Objective To investigate the sffectiveness of lymphocyte active immunotherapy in patients with unexplained recurrent spontaneous abortion（URSA）and the changes of blocking antibody（BA）before and after the treatment and to analyze the relationship of abortion time and patients, age with the outcomes of URSA after lymphocyte active immunotherapy. Methods 89 URSA patients with negative blocking antiboies were immunized with lymphocytes. The changes of BA after the treatment and the outcome of subsequent pregnancy were observed. Results ①89 URSA patients were negative blocking antiboies before lymphocyte active immunotherapy. 36（40.4%）were positive after 3 immunization.42（47.2%）were positive after 6 immunization. The positive rate was 88.76%（79/89）. ② 79 of 89 patients with the treatment were successfully conceived. The successful rate of pregnancy in positive BA was higher than that in negative BA. There was significant difference（P〈0.05）.③The pregnancy Success rate of abortion time less than or equal to 3 was significantly higher than that of abortion time more than 3（P〈0.05）.④The pregnancy success rate of age group under 35 was significantly higher than the age group above 35（P〈0.05）. Conclusion Lymphocyte active immunotherapy can improve the successful rate of subsequent pregnancy in blocking antibody-negative patients with URSA, and raise the positive rate of blocking antibody. URSA patients should be interfered and treated as early as possible.