异体淋巴细胞免疫治疗不明原因复发性流产巢式病例对照研究  

Allogeneic Lymphocyte Immunotherapy for Primary Unexplained Recurrent Miscarriage: a Randomized Nested Placebo-Controlled Trial

作　　者：陈雷宁[1] 裘毓雯[1] 欧湘红[1] 陈思梅[1] 全松[1] 

机构地区：[1]南方医科大学南方医院,广东广州510515

出　　处：《实用妇产科杂志》2014年第4期295-298,共4页Journal of Practical Obstetrics and Gynecology

基　　金：广东省自然科学基金(编号:S2011010003916)

摘　　要：目的：探讨异体淋巴细胞免疫治疗（ALIT）对不明原因复发性流产（URM）的治疗价值。方法：采用前瞻性、随机、患者单盲、巢式病例对照研究方法，将南方医院生殖医学中心2008年7月至2012年4月符合条件的638例URM患者随机分为ALIT组（314例）和对照组（324例）。ALIT组进行ALIT6～8次复查封闭抗体转阳后积极试孕；对照组仅予0．9％氯化钠液注射。比较两组的临床特征和妊娠结局。结果：①两组既往平均流产次数、既往流产平均孕周、体重指数和再次妊娠年龄比较，差异均无统计学意义（P〉0．05）。②两组末次治疗后1年内受孕方式比例、异位妊娠率、再次流产率、流产胚胎异常染色体核型比例、严重母胎并发症发生率、粗活产率和校正活产率比较，差异均无统计学意义（P〉0．05）。结论：ALIT不能对URM再次妊娠有明显的保胎作用。Objective： To explore whether primary unexplained recurrent miscarriage （URM） patients could benefit from allogeneic lymphocyte immunotherapy（ALIT） . Methods： Between July 2008 and April 2012,638 URM patients who met the enrollment criteria were recruited. They were randomly assigned to re- ceive ALIT 6-8 times （ALIT group, n = 314） until the serum blocking factors turned positive before concep- tion or the equivalent volume of the placebo normal saline infusion （control group, n =324）. All their clinical characteristics and pregnancy outcomes within one year after therapy were collected and compared. Re- sults ：①The demographic characteristics, including initiation attendant age, mean previous miscarriage num- ber, mean termination gestational weeks of previous miscarriage, body mass index and current pregnancy age were similar between the two groups（ P〉0. 05）. ②Both the ALIT and the control groups had similar conception route ratio, pregnancy rate, ectopic pregnancy rate, repeated miscarriage rate, abnormal con- ceptus chromosome ratio, severe pregnancy complications（pre-eclamsia, placental abruption, premature rupture of membranes, preterm births and fatal major defects） ratio, rough live birth rate and live birth rate adjusted by abnormal conceptus chromosome/fatal major defects（ P 〉0. 05）. Conclusions：ALIT could not improve the URM subsequent live birth rate as compared with placebo.

关 键 词：不明原因复发性流产 封闭抗体 异体淋巴细胞免疫治疗 

分 类 号：R714.21[医药卫生—妇产科学]