环孢素A联合淋巴细胞治疗URSA对患者血清T细胞亚群、ACA及妊娠结局影响

目的:探讨环孢素A(CsA)联合淋巴细胞主动免疫(LIT)对原因不明复发性流产(URSA)患者血清T细胞亚群、抗心磷脂抗体(ACA)水平变化及妊娠结局的影响。方法:选择2015年1月—2017年1月本院妇产科收治的URSA患者100例,随机分为两组各50例,观察组采用CsA联合LIT治疗,对照组采用LIT治疗。观察两组治疗前后T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、ACA抗体(ACA-IgM、ACA-IgG)水平,对比两组妊娠结局。结果:治疗后两组CD3+、CD4+、CD4+/CD8+升高、CD8+降低,且观察组变化幅度优于对照组(均P<0.05)。两组ACA-IgM、ACA-IgG均下降,且观察组低于对照组(均P<0.05)。观察组成功分娩率(92.0%)高于对照组(72.0%),流产率(4.0%)、妊娠期高血压发生率(2.0%)低于对照组(18.0%、16.0%)(均P<0.05)。结论:CsA联合LIT治疗可显著降低ACA抗体水平,提高免疫功能,降低流产率,改善妊娠结局,效果优于单独LIT治疗。

Influence of cyclosporine A combined with lymphocyte active immunization for treating women with unexplained recurrent spontaneous abortion on their serum T cell subsets level,ACA level and pregnancy outcomes

Objective:To investigate the influence of cyclosporine A(CsA)combined with lymphocyte immunization of T cell(LIT)fro treating women with unexplained recurrent spontaneous abortion(URSA)on their serum T cell subsets,anticardiolipin antibody(ACA)level,and pregnancy outcomes.Methods:100 pregnant women with URSA were enrolled and were devided into study group and control group(50 cases in each group).The women in the study group were treated by CSA combined with LIT,and the women in the control group were treated by LIT.The levels of T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)and ACA antibodies(ACA-IgM,ACA-IgG)of all women were observed before and after treatment,and the pregnancy outcomes of women was compared between the two groups.Results:Ather treatment,Values of CD3+,CD4+,and CD4+/CD8+of women in the study group had increased significantly,but CD8+value and levels of ACA-IgM and ACA-IgG of women in the study group had decreased significantly,and the change degree of women in the study group were significant more than that of women in the control group(P<0.05).The successful delivery rate of women in the study group was 92.0%,which was significant higher than that(72.0%)of the control group(P<0.05).The incidences of abortion and pregnancy-induced hypertension of women in the study group were 4.0%and 2.0%,which were significant lower than those(18.0%and 16.0%)of women in the control group(P<0.05).Conclusion:CsA combined with LIT used for treating women with URSA can significantly reduce ACA antibody levels,improve immune function,reduce abortion rate,and improve pregnancy outcome,which’s effect is better than LIT used alone.