人类白细胞抗原基因多肽性与不明原因反复流产免疫治疗妊娠结局的初步探讨  

Study on the Polimorphisms of the Human Leukocyte Antigen Gene and the Outcome of Pregnancy of Unexplained Recurrent Spontaneous Abortion Treated with Paternal Lymphocyte Alloimmunization Therapy

作　　者：郑妍[1] 何庭宇[1] 何茜冬[1] 易冰[2] 季明芳[2] 

机构地区：[1]广东省中山市人民医院生殖中心,中山528403 [2]广东省中山市人民医院肿瘤研究所,中山528403

出　　处：《生殖与避孕》2010年第3期174-176,186,共4页Reproduction and Contraception

摘　　要：目的:探讨人类白细胞抗原(HLA)基因多态性对不明原因反复流产(URSA)免疫治疗疗效的预测价值。方法:①采用酶联免疫法(ELISA)测定URSA患者免疫治疗前、免疫治疗一疗程后封闭抗体(BA),并随访阳性者与阴性者的妊娠率。②采用52例封闭抗体阴性的URSA患者进行主动免疫治疗,随机抽取32例于免疫治疗前用SSP-PCR方法测定患者免疫治疗前及妊娠后血浆内的HLA-A、B、DR及G的表达率。结果:①免疫治疗后BA阳性者及阴性者的妊娠成功率差异无统计学意义,P>0.05。②HLA-G*010401及HLA*1502的表达频率在再次流产者中明显高于成功妊娠者,组间比较差异均有统计学意义(分别为P<0.01,P<0.05)。结论:HLA基因的多态性与免疫治疗妊娠结局似乎有更好的相关性,其中HLA-G*010401、HlA-DRB1*1502与免疫治疗后妊娠结局关系密切,有可能成为有价值的预测指标。Objective：To research the predictive value of the human leukocyte antigen gene（HLA） for the outcome of unexplained recurrent spontaneous abortion（URSA） treated with paternal lymphocyte alloimmunization therapy（PLAT）.Methods：Totally 52 URSA patients were enrolled in this study without blocking antibody（BA） before treatment.The study group：the frequencies of HLA-G010401,DRB11502,A2402 and B5201 were measured by SSP-PCR in 32 of 52 women without blocking antibody（BA）.The frequencies of HLA were compared between the successful pregnancy cases and aborted cases after PLAT.Control group：Blocking antibody were tested by ELISA before and after PLAT in 52 RUSA cases.Pregnancy outcome was followed between the BA（＋） cases and BA（-） cases after PLAT.Results：The frenquencies of HLA_G010401 and HLA-DRB11502 were significantly increased in the aborted cases than those in the successful cases,and there was a statistically difference（P0.01,P0.05）.Otherwise,there was no statistical difference in the successful pregnancy rate between cases with BA（＋） and BA（-）,P0.05.Conclusion：The polimorphisms of HLA is closer related to the outcome of pregnancy of URSA with PLAT,specially HLA-G010401,HlA-DRB11502.They may become valuable prective factors.

关 键 词：人类白细胞抗原基因(HLA) 封闭抗体(BA) 淋巴细胞免疫治疗 

分 类 号：R714.21[医药卫生—妇产科学] R446.6[医药卫生—临床医学]