淋巴细胞主动免疫治疗原因不明复发性流产后HLA-DR抗体检测及意义  

Deletection and significance of HLA-DR antibody after lymphocyte initiative immunotherapy for unexplained repetitive spontaneous abortion

作　　者：刘红彦[1,2,3] 廖世秀[1,2,3] 侯巧芳[1,2,3] 郭谦楠[1,2,3] 郭社珂[4] 何淼[1,2,3] 楚艳 

机构地区：[1]河南省人民医院 [2]郑州大学人民医院 [3]河南省医学遗传研究所,郑州市450003 [4]焦作市人民医院妇产科,河南省454100

出　　处：《中华实用诊断与治疗杂志》2012年第8期741-743,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(81170581);河南省医学科技攻关计划项目(2011020123)

摘　　要：目的探讨淋巴细胞主动免疫治疗原因不明的反复自然流产后患者免疫功能变化及其对妊娠结局的影响。方法选取确诊为原因不明的复发性流产患者350例,应用自身对照法,采用配偶或第三方个体淋巴细胞主动免疫治疗,检测和记录免疫治疗前后患者封闭抗体(HLA-DR抗体)的变化及妊娠成功率。结果符合入组条件321例,经淋巴细胞主动免疫治疗1个疗程后,封闭抗体转为阳性195例(60.75%),2个疗程后累计转为阳性315例(98.13%);封闭抗体转为阳性患者中309例(98.09%)妊娠成功,6例封闭抗体持续阴性者仅3例妊娠成功。结论淋巴细胞主动免疫治疗可有效提高原因不明复发性流产患者妊娠成功率;封闭抗体检测对评估原因不明复发性流产有一定价值。Objective To evaluate the changes of immune function after lymphocyte initiative immunotherapy for unexplained repetitive spontaneous abortion （URSA） and the influence on the outcome of pregnancy. Methods A total of 350 patients with URSA were detected and recorded the changes of blocking antibodies （HLA-DR antibody） before and after immunotherapy and the pregnancy success rates, with the self-calibrated method and the spouse or third party individual lymphocytes. Results Of these 350 cases, 321 cases accorded with conditions, in which 195 cases （60.75%） acquired the positive blocking antibodies after one course of therapy, and 315 cases （98. 13%） acqiured positive results after two courses of therapy. The pregnancy rate was 98.09% （309/315） in patients with transformed positive blocking antibodies. Only 3 patients got pregnant in 6 patients with continued negative antibody. Conclusion The initiative immunotherapy is an effective method to treat unexplained repetitive spontaneous abortion. The detection of blocking antibodies is valuable for evaluating URSA.

关 键 词：复发性流产 原因不明 封闭抗体 主动免疫治疗 

分 类 号：R714.21[医药卫生—妇产科学]