低分子肝素对URSA患者外周血免疫细胞的影响  

The effect of low molecular weight heparin on peripheral blood immune cells from patients with unknownreason recurrent spontaneous abortion

作　　者：王芳[1,2] 刘瑞霞[1,2] 王英兰[1,2] 周雅莹[1,3] 

机构地区：[1]暨南大学附属第二医院 [2]深圳市人民医院妇产科,广东深圳518001 [3]深圳市人民医院检验科,广东深圳518001

出　　处：《中国优生与遗传杂志》2014年第6期66-68,共3页Chinese Journal of Birth Health & Heredity

基　　金：深圳市科技计划项目;项目编号201103359

摘　　要：目的探讨低分子肝素对不明原因复发性流产（URSA）患者外周血免疫细胞的影响。方法研究组包括28例URSA患者,予低分子肝素（Fraxiparine 0.4-0.6ml/d或Enoxaparin 0.4-0.6ml/d iH）治疗至妊娠12w,于治疗前、3w后采用流式细胞术检测患者外周血中淋巴细胞亚群及血常规;15例未接受低分子肝素治疗的URSA患者为对照组,于首次就诊（血HCG确认妊娠）及2~3w后（流产清宫前）检测以上项目。结果研究组保胎成功率为86%,明显高于对照组33%（P〈0.05）;使用低分子肝素后USRA患者外周血中总T细胞数比例为（66.9±5.6）%,较使用前（61.2±7.4）%升高（P〈0.05）;NK细胞比例为（16.6±4.4）%,较使用前（19.4±7.3%）下降（P〈0.05）,中性粒细胞比例为（67.1±7.9）%,红细胞压积为（36.1±3.9）%,较使用前（70.7±7.8%）、（33.8±7.8%）均下降（P〈0.05）。结论低分子肝素对URSA有显著治疗效果,其作用机理除抗凝外,还可能直接降调URSA外周血中的NK细胞及中性粒细胞。Objective：To explore the effect of low molecular weight heparin（LMWH）on peripheral blood immune cells from patients with unknown-reason recurrent spontaneous abortion（URSA）. Methods：Twenty-eight URSA patients were treated with LMWH（Fraxiparine 0.4~0.6ml/d or Enoxaparin 0.4~0.6ml/d iH）until 12 weeks with pregnancy. The lymphocyte subsets in the peripheral blood were examined by flowcytometry and complete blood count（CBC）were assessed before and 3weeks after treatment. Fifteen URSA patients without LMWH treatment were included in the control group. Results：The ratio for successful abortion-prevention was 86% in the experimental group,which is significantly higher than that in the control group（33%）. In the experimental group,there were significant differences for the percentage of T cells（61.2±7.4 vs66.9±5.6%）,NK cells（19.4±7.3% vs 16.6±4.4%）,neutrophils（70.7±7.8% vs 67.1±7.9%）and hematocrit（33.8±7.8% vs 36.1±3.9%）before and after LMWH treatment.Conclusion：LMWH has a profound effect on patients with URSA. The underlying mechanisms may include the anti-coagulation effect and the down-regulation of NK cells and neutrophils in the peripheral blood.

关 键 词：低分子肝素 复发性流产 NK细胞 流式细胞术 

分 类 号：R714.21[医药卫生—妇产科学]