反复流产患者主动免疫治疗前后T淋巴细胞封闭效率比较

目的 通过检测、分析反复流产(RSA)患者主动免疫治疗前后外周血中T淋巴细胞CD3+、CD4+和CD8+封闭效率变化,评价主动免疫治疗的疗效,探讨RSA发生的免疫学机制。 方法 选取3次或3次以上无明确原因的自然流产患者82例,使用流式细胞仪对这82例RSA患者主动免疫治疗前后外周血中T淋巴细胞CD3+、CD4+和CD8+封闭效率进行检测,采用Wilcoxon符号秩检验分析主动免疫治疗前后封闭效率的差异,采用χ2检验来分析封闭效率转阳与否与妊娠结局的关系。 结果 主动免疫治疗后RSA患者外周血中T淋巴细胞CD3+和CD8+的封闭效率明显升高,免疫治疗前CD3封闭效率为0.31(-0.51~1.09),免疫治疗后CD3封闭效率为1.02(0.09~2.33);免疫治疗前CD8封闭效率为0.47(-0.53~1.83),免疫治疗后CD8封闭效率为1.39(0.55~2.88),差异有统计学意义(Z=-2.147、-2.622,P<0.05),而CD4+的封闭效率免疫治疗前为-0.04(-1.40~1.30),免疫治疗后为0.52(-1.10~1.35),有升高的趋势,但差异无统计学意义(Z=-0.552,P>0.05)。RSA患者经过主动免疫治疗后转阳和未转阳的妊娠率分别是42.9%和16.1%,转阳的患者妊娠率明显高于未转阳的患者,差异有统计学意义(P<0.05)。 结论 RSA患者经过主动免疫治疗后,其外周血T淋巴细胞封闭效率提高,封闭抗体的阳性转变更有利于妊娠的建立和维持。 

The changes of T lymphocytes blocking efficiency after active immunotherapy in recurrent spontaneous abortion patients

Objective To detect the changes of T lymphocytes CD3+,CD4+ and CD8+ blocking efficiency after initiate immunotherapy,monitor the effect of immunotherapy and explore the immunological occurrence mechanism of RSA. Methods A total of 82 patients with three times or more than 3 times unexplained recurrent spontaneous abortion patients were selected.Flow cytometry was used to measure T lymphocytes CD3+,CD4+ and CD8+ blocking efficiency of these 82 patients,Wilcoxon rank sum test were used to analyze the difference between two groups,Chi-square test was used to analyze the relationship between positive changing of T lymphocytes blocking efficiency and the result of pregnancy. Results The level of CD3+,CD8+ T lymphocytes blocking efficiency was significantly increased in peripheral blood of unexplained recurrent abortion patients after initiate immunotherapy (Z=-2.147,-2.622,P<0.05),CD3+ T lymphocytes blocking efficiency before active immunotherapy were 0.31(-0.51 to 1.09),CD3+ T lymphocytes blocking efficiency after active immunotherapy were 1.02(0.09 to 2.33);CD8+ T lymphocytes blocking efficiency before active immunotherapy were 0.47(-0.53 to 1.83),CD8+ T lymphocytes blocking efficiency after active immunotherapy were 1.39(0.55-2.88),while there is no significantly differences in CD4+ although blocking efficiency were slightly unregulated (Z=-0.552,P>0.05),CD4+ T lymphocytes blocking efficiency before active immunotherapy were-0.04(-1.40 to 1.30),CD4+ T lymphocytes blocking efficiency after active immunotherapy were 0.52(-1.10 to 1.35).After active immunotherapy,the pregnancy rate of positive blocking efficiency is 42.9%.he pregnancy rate of negative blocking efficiency is 19.4%.The pregnancy rate was higher in the RSA patients with positive blocking efficiency than the patients with negative blocking efficiency (P<0.05). Conclusion After active immunotherapy,T lymphocytes blocking efficiency of peripheral blood recurrent spontaneous abortion patients were unregulated,T lymphocytes blocking efficiency increasing after active immunotherapy in recurrent abortion patients may be helpful to maintain pregnancy.