IVF-ET前的HLA主动免疫预处理对98例不孕症治疗效果探讨  

Analysis of HLA active specific immunotherapy for 98 cases of infertility before IVF-ET

作　　者：周淑[1] 严凤英[2] 靳松[1] 

机构地区：[1]四川大学华西第二医院妇产科生殖中心,四川成都610041 [2]四川省人民医院城东病区,四川成都610101

出　　处：《四川医学》2012年第10期1683-1684,共2页Sichuan Medical Journal

基　　金：四川省科技厅支撑项目(编号:2009SZ0198)

摘　　要：目的观察体外受精-胚胎移植(IVF-ET)前应用HLA主动免疫预处理治疗不孕症的疗效。方法建议65例原发不孕症患者和33例继发不孕患者用丈夫淋巴细胞进行前臂内侧皮内注射,注射分6～8点进行。每2周治疗1次,3次为1个疗程。对于HLA-DR抗体复查阴性者加强免疫治疗1～2个疗程。确认宫内妊娠后加强免疫治疗1～2个疗程。结果在65名原发不孕和33名继发不孕患者中,经HLA主动免疫治疗1个疗程后HLA-DR抗体转阳者分别为32例和15例,转阳率分别为82%和88%;经过2个疗程疗后HLA-DR抗体转阳者分别为15例和11例,转阳率分别为79%和85%;经3个疗程疗后HLA-DR抗体转阳者分别为3例和2例,转阳率分别为43%和67%。98名不孕症患者最终成功妊娠45例,成功率达46%。结论 HLA主动免疫疗法可有效提高HLA-DR抗体阴性不孕症患者妊娠成功率,HLA-DR抗体检测可作为免疫因素引起的不孕症临床诊断和免疫治疗的指标之一。Objective To assess the validity of HLA active specific immunotherapy for infertility.Methods This study was conducted in 98 URSA patients who were given intradermal injection of their husbands＇ leukomonocyte once two weeks.The injection sites were divided into 6~8 areas.Then they came to the secondary therapy course after six weeks.One or two more therapy courses should be used in these patients who got negative results of HLA-DR antibody testing and pregnant patients.Results 32 patients of primary infertility and 15 patients of secondary infertility were HLA-DR antibody positive after one course of HLA active therapy,and the effective rate was82% and 88% respectively.15 patients of primary infertility and 11 patients of secondary infertility got the positive results of HLA-DR antibody after two courses of HLA active therapy,and the effective rate was 79% and 85%.HLA-DR antibody of 32 patients of primary infertility and 2 patients of secondary infertility changed to positive after three courses of HLA active therapy,and the effective rate was 43% and 67% respectively.45 patients were pregnant after HLA active immunotherapy,and the achievement ratio was 46%.Conclusion HLA active specific immunotherapy may increase the pregnancy rate of infertility patients with negative HLA-DR antibody.HLA-DR antibody can be a useful marker for the diagnosis and immunotherapy of infertility.

关 键 词：HLA 主动免疫治疗 不孕症 

分 类 号：R711.6[医药卫生—妇产科学]