淋巴细胞免疫疗法治疗习惯性流产的疗效及机制研究

目的：探讨封闭抗体与淋巴细胞免疫疗法治疗习惯性流产的关系及疗效。方法选择100例封闭抗体阴性不明原因习惯性流产病例，其中60例（试验组）进行淋巴细胞免疫治疗，并于治疗后复查封闭抗体、T 细胞亚群和 IgG、IgM 含量的改变，另40例（对照组）采用常规方法保胎治疗，对比两组妊娠结局。结果试验组妊娠成功率为81.7%，对照组为37.5%，二者有统计学差异（P 〈0.01）。试验组封闭抗体阳性者妊娠成功率为90.3%，封闭抗体阴性者为33.3%，亦有统计学差异（P 〈0.01）。试验组 CD4＋ T 细胞较治疗前下降，CD8＋ T 细胞治疗后上升， CD4＋/ CD8＋下降，IgG 与 IgM 治疗后亦下降明显，以上各指标免疫治疗前后均有显著差异（P 均〈0.05）。结论封闭抗体对妊娠结局有一定影响，封闭抗体阴性患者进行淋巴细胞免疫治疗，安全方便，疗效肯定，值得加强推广。

The study of effect and mechanism of lymphocytes immunotherapy about habitual abortion

ObJective：To investigate the relationship and effect of blocking antibody and lymphocytes immunotherapy in recurrent spontaneous abortion. Methods：Of one hundred blocking antibody-negative patients with unexplained recurrent spontaneous abortion（URSA）,60 patients（trial group）were chosen and treated with immunotherapy,and the changes of subtypes of lymphocytes and IgG,IgM were observed after immunotherapy,40 patients（control group）were treated with routine tocolysis,and the results were compared between the two groups. Results：The pregnancy success rate of trial group was 81. 7% ,but the control group was 37. 5% ,and there was a significant difference between the two groups（P 〈 0. 01）. The pregnancy success rate of blocking antibody - positive in the trial group was 90. 3% ,and that of blocking antibody-neg-ative was 33. 3% ,and there also was a significant difference between them（P 〈 0. 01）. In the trial group,after immunother-apy the amount of CD4 ＋ T cells was significantly lower;the amount of CD8 ＋ T cells was significantly higher;the ratio of CD4 ＋ T/ CD8 ＋ T was significantly lower than that before immunotherapy;the levels of IgG and IgM were significantly low-er. There was significant difference in all indexes before and after the treatment（P 〈 0. 05,all）. Conclusion：Blocking anti-body can influence the result of pregnancy. Lymphocytes immunotherapy is safe,convenient and effective for patients with blocking antibody-negative,and it is well worth popularizing.