丙种球蛋白被动免疫治疗原因不明性反复自然流产研究  

The treatment of unexplained recurrent spontaneous abortion women with intravenous immunoglobulin

作　　者：陈巧儿[1] 秦卫兵[1] 叶嘉玲[1] 杨宁[1] 王一峰[1] 刘玉兰[1] 许玉芳[1] 

机构地区：[1]广东省计划生育科学技术研究所,510600

出　　处：《中国妇幼保健》2007年第23期3260-3262,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨静脉点滴丙种球蛋白治疗原因不明性反复自然流产(URSA)的疗效及治疗前后机体封闭抗体、T细胞亚群、胞内Th1/Th2细胞因子及外周血NK细胞含量的变化,以期初步阐明其治疗机理。方法:URSA患者治疗前均检测封闭抗体,对于封闭抗体阴性的患者给予每2周静脉点滴10g国产丙种球蛋白,连续4次治疗后再次检测封闭抗体。怀孕后改为每3周同剂量加强免疫一次,至怀孕26～30周。应用FACSCalibur流式细胞仪分析25例患者治疗前后外周血T淋巴细胞亚群、胞内Th1/Th2细胞因子及NK细胞的变化,并选择20例正常妊娠并选择人工流产者作为对照组。结果:25例URSA经4次被动免疫治疗后有19例封闭抗体转阳性。21例能正常怀孕并成功分娩,4例流产,成功率84%。治疗后CD3+T细胞百分比略升高但无显著性差异;CD8+T细胞百分比有明显升高;而CD4+T细胞百分比明显下降;CD4+/CD8+比率也明显下降。胞内Th2型细胞因子IL-10含量显著性升高;胞内Th1型细胞因子IFN-γ和外周血NK细胞含量明显下降。结论:静脉点滴丙种球蛋白治疗URSA具有较好疗效。治疗后机体免疫保护作用明显增强,可能是丙种球蛋白促进妊娠发展的原因之一。Objective： To investigate the effectiveness and the changes of blocking antibody, T lymphocyte subpopulations, intracellular Th1/Th2 cytokines and NK cell percentage of treatment with intravenous immunoglobulin in unexplained recurrent spontaneous abortion women. Methods： 25 women were received treatment with immunoglobulin at a close of 10 g within 2 weeks for 4 times before pregnancy. Once conception was achieved, immunogiobulin treatment was continued on 3 monthly basis at same dose within 3 weeks through 26 - 30 weeks of gestation. Flow cytometry was used to measure T lymphocyte subpopulations and intracellular Th1/Th2 cytokines and NK cell percentage of all women participants with RSA. Results： Of 25 women continued immunoglobulin treatment through 26 - 30 weeks of gestation, there are 19 CDC positive after immunotherapy, 21 （84%） had a successful term pregnancy. We have also observed immunized women with RSA showed significantly increased percentage of CD4^ ＋ cells, CD4^＋/CD8^＋ ratio, intracellular IL - 10, and significantly decreased percentage of CD8^＋ cells, intracellular IFN -γ and NK cell percentage as compared to before immunotherapy. Conclusion： The treatment of unexplained recurrent spontaneous abortion women with intravenous immunnglobulin is effective and useful for pregnancy development.

关 键 词：丙种球蛋白 原因不明性反复自然流产 被动免疫 

分 类 号：R714.21[医药卫生—妇产科学]