配偶淋巴细胞免疫治疗次数和注射方式对复发性流产患者封闭抗体转阳率的影响  

Study on positive rate of blocking antibody in women with recurrent spontaneous abortion administered by route and frequency of paternal lymphocyte immunotherapy

作　　者：于红玲[1] 邓晓惠[1] 晁岚[1] 陈超[1] 韩亦龙[1] 

机构地区：[1]山东大学齐鲁医院不孕不育诊疗中心,济南250012

出　　处：《中华妇产科杂志》2013年第12期903-906,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨配偶淋巴细胞免疫治疗次数和注射方式对复发性流产患者封闭抗体转阳率的影响。方法回顾性分析2008年1月至2012年8月在山东大学齐鲁医院不孕不育诊疗中心进行配偶淋巴细胞免疫治疗的复发性流产患者326例的临床资料，共分为两组，皮内注射组260例，采用双侧前臂皮内注射法进行淋巴细胞免疫治疗，每21天1次，并分别于免疫治疗2（23例）、3（73例）、4（74例）、5（90例）次后2周测定封闭抗体；皮下注射组66例，采用皮下注射法，进行淋巴细胞免疫治疗，同样为每21天1次，治疗5次，并于治疗第3次后2周测定封闭抗体。计算封闭抗体转阳率，随访并计算封闭抗体转阳后再次妊娠的成功率。结果（1）封闭抗体转阳率：皮内注射组2、3、4、5次免疫治疗后，封闭抗体转阳率分别为17％（4／23）、58％（42／73）、72％（53／74）、84％（76／90），分别比较，差异均有统计学意义（P〈0．05）。免疫治疗3次后皮下注射组封闭抗体转阳率为38％（25／66），明显低于皮内注射组的封闭抗体转阳率（58％，42／73）。差异也有统计学意义（P〈0．05）。（2）封闭抗体转阳患者的妊娠率：封闭抗体转阳的200例患者中，妊娠176例，其中成功妊娠（妊娠而且时间≥5个月）126例，11例妊娠但时间〈5个月，成功妊娠率为71．6％（126／176），流产39例。结论免疫治疗次数和注射方式影响封闭抗体转阳率；封闭抗体转阳后可提高再次妊娠的成功率。Objective To investigates factors affecting the positive rate of blocking antibody treated by paternal lymphocyte immunotherapy in patients with recurrent spontaneous abortion （RSA）. Methods From January 2008 to August 2012, 326 RSA cases undergoing treatment in Infertility Center of Qilu Hospital were studied retrospectively. Those patients were divided into 2 groups randomly： 260 cases in intradermal injection group were administered via bilateral forearm intradennal injections for immunotherapy once 21 days, then the blocking antibody was determined after 2 （ 23 cases） ,3 （73 cases） ,4 （ 74 cases）, 5 （90 cases） times respectively, while in subcutaneous injection group, the 66 cases were administered via subcutaneous injection once 21 days, the blocking antibody measured after 3 times; In both cases, the blocking antibody was all determined 2 weeks later. The positive rate of blocking antibodies and the rate of successful pregnancy was recorded, and then followed up after the blocking antibody turning positive. Results （ 1 ）Positive rate of blocking antibodies：the positive rate of blocking antibodies were 17% （4/23） ,58 % （42/ 73 ） ,72% （53/74） and 84% （76/90） in the 2,3,4, and 5 times of intradermal injection group, respectively （P 〈 0. 05）. In subcutaneous injection group, the positive rate of blocking antibodies was 38 % （25/66） , which was significantly lower than that in group intradermal injection receiving 3 times immunotherapy （ P 〈 0. 05）. （2） The rate of pregnancy：the 176 patients out of 200 patients were pregnant when antibody was positive after immunotherapy, with 71.6% （126/176）of patients gained successful pregnancy（ the length of pregnaney more than 5 months）. Conclusions The route and frequency of administration of immunotherapy could influence the positive rate of blocking antibody. The rate of successful pregnancy will be increased after blocking antibody turning positive.

关 键 词：流产 习惯性 免疫疗法 过继 免疫球蛋白G 

分 类 号：R714.21[医药卫生—妇产科学]