复发性流产患者免疫治疗前后T淋巴细胞表达率与治疗效果的临床观察

目的:观察封闭抗体为阴性的复发性流产(RAS)患者免疫治疗前后外周血中CD3+、CD4+和CD8+的表达,探讨淋巴细胞免疫治疗的效果。方法:对181例封闭抗体阴性RAS患者采用双荧光标记流式细胞分析技术,以丈夫或健康男性的淋巴细胞为抗原靶标,测定患者免疫治疗前后血清中CD3+、CD4+和CD8+的表达率,并随访妊娠情况。结果:主动免疫治疗后外周血中CD3+、CD4+和CD8+的表达率明显高于治疗前(P0.01);181例患者治疗后封闭抗体转为阳性37例,妊娠30例(86%);未转阳110例,妊娠7例(6%),妊娠率差异有统计学意义(P0.05)。结论:对封闭抗体阴性的RAS患者行淋巴细胞主动免疫治疗,有助于提高其妊娠率。

Treatment effects and different expressions of T lymphocyte before and after immunization therapy in patients with recur- rent abortion

Objective： To observe different expressions of CD3＋ , CD4＋ and CD8＋ in the peripheral blood among recurrent spontaneous abortion patients with negative blocking antibody before and after immunotherapy and to evaluate the effect of lymphocyte immunotherapy. Methods： A total of 181 recurrent spontaneous abortion patients with negative blocking antibodiy were immunized with lymphocytes. The expression rates of CD3＋ , CD4＋ and CD8＋ of 181 patients were examined before and after immunotherapy by double fluorescent marker flow cytometric. The outcome of subsequent pregnancy was followed up. Results： The expression rates of CD3＋ , CD4＋ and CD8＋ in the peripheral blood after active immunotherapy were statistically higher than those before the therapy （P〈0.01）. The blocking antibody of 37 patients changed from negative to positive after treatment, and 30 patients successfully conceived （86%）. But a- mong 110 patients whose blocking antibodies were still negative, only 7 successfully conceived （6M）. There was significant difference in the pregnancy rate between those with negative blocking antibody and positive one （P d0.05）. Conclusion： The T--cell--based active immunotherapy could improve the successful rate of the subsequent pregnancy in recurrent spontaneous abortion patients with negative blocking antibody.