主动免疫联合安胎治疗原因不明习惯性自然流产临床研究

目的:对比单纯主动免疫治疗和主动免疫联合HCG及黄体酮安胎治疗原因不明自然流产的疗效,探讨临床治疗原因不明习惯性流产的适宜方案。方法:205例原发性或继发性原因不明习惯性流产患者随机分为2组。A组105例,接受主动免疫治疗,妊娠后立即联合HCG及黄体酮安胎治疗;B组100例,单纯接受主动免疫治疗。结果:治疗后A组妊娠成功率为90.48%(95/105),B组妊娠成功率为83.00%(83/100),A组、B组比较差异无统计学意义(P>0.05)。205例主动免疫治疗后封闭抗体转为阳性133例,其中113例成功妊娠,妊娠成功率84.96%,封闭抗体仍为阴性72例中,成功妊娠58例,妊娠成功率80.56%,二者比较差异无统计学意义。结论:主动免疫治疗原因不明自然流产原则上不需联合HCG及黄体酮安胎治疗;可根据个体情况联合应用HCG及黄体酮安胎治疗;主动免疫治疗后封闭抗体转阳与否与妊娠结局无相关性。

The clinical research of treatment of unexplained recurrent spontaneous abortion by immunotherapy combined with HCG and Progesterone

Objective:To compare the clinical effect of treatment the patients with unexplained recurrent spontaneous abortion(URSA) by immunotherapy only and immunotherapy combined with human chorionic gonadotropin(HCG),Progesterone.To evaluate the proper therapeutic strategy to treat URSA. Methods:205 cases with primary or secondary URSA were randomly divided into two groups: 105 cases(group A) were treated with immunotherapy combined with human chorionic gonadotropin(HCG)and Progesterone,100 cases(group B) simply with immunotherapy. Results:The rate of successful pregnancy of group A,B were 90.48%,83% respectively.There were no significant differences between group A and B(P>0.05).After active immunotherapy,133 cases had positive blocking-antibody,and 113 cases obtained successful pregnancy.The successful pregnant rate of the positive blocking-antibody patients was 84.96%(113/ 133);The successful pregnant rate of the negative blocking-antibody patients was 80.56%(58/ 72).There was no significant difference in two groups(P>0.05). Conclusion:It is unnecessary to treat the whole URSA by immunotherapy combined with HCG and Progesterone,but it is useful when individual need.The blocking-antibody is not a predictor for successful pregnancy.