白蛋白保护下淋巴细胞主动免疫治疗复发性流产的研究  

Study on lymphocyte active immunotherapy under albumin protection in treatment of recurrent spontaneous abortion

作　　者：杨如[1] 杨君[1] 许芝山[1] 蔡瑞艳[1] 钟根深[1] 

机构地区：[1]新乡医学院第一附属医院神经病学研究所,河南卫辉453100

出　　处：《中国妇幼保健》2014年第21期3478-3480,共3页Maternal and Child Health Care of China

基　　金：河南省人口和计划生育科学技术研究课题(20121026)

摘　　要：目的：探讨淋巴细胞主动免疫治疗（LIT）反复自然流产（RSA）的临床疗效，为临床治疗RSA提供客观依据。方法：选取2010年1月-2012年12月该院门诊确诊的RSA患者60例，采用流式细胞术在不同的时间点检测10％浓度白蛋白保护下淋巴细胞CD3＋、CD3＋CD8＋、CD3＋CD4＋水平的变化，并对患者体内封闭抗体（BA）进行流式细胞术测定，对BA阴性患者进行LIT治疗，治疗后检测BA的变化及再次妊娠情况。结果：在10％浓度白蛋白保护下，0～90天内，CD3＋、CD3＋CD8＋、CD3＋CD4＋细胞的比例比较，差异无统计学意义（P〉0．05），120～180天内，细胞比例显著下降，差异有统计学意义（P〈0．05）；流式细胞术检测RSA患者BA阳性率为6．7％，经LIT治疗后，BA阳性率达到78．3％，与治疗前比较，差异有统计学意义（P〈0．05）；BA阳性者再次妊娠成功率为87．2％，BA阴性者为33．3％，两者比较，差异有统计学意义（P〈0．05）。结论：10％浓度的白蛋白在一定时间（≤180天）对低温冷冻下的淋巴细胞具有较好的保护作用，采用此低温冻存的淋巴细胞治疗RSA患者具有较好的疗效，减轻了淋巴细胞供者多次采血的痛苦，降低了重复操作过程带来的污染几率，使治疗过程更加安全和有效。Objective： To explore the clinical efficacy of lymphocyte active immunotherapy （LIT） in treatment of recurrent sponta- neous abortion （RSA）, provide a objective basis for treating RSA in clinic. Methods： Sixty patients diagnosed as RSA definitely in outpa- tient department of the hospital from January 2010 to December 2012 were selected, flow cytometry was used to detect the changes of CD3＋ , CD3＋ CD8 ＋ and CD3 ＋ CD4＋ lymphocytes under protection of 10% concentration of albumin at different time points, blocking antibody （BA） of the patients was detected by flow cytometry; LIT was used to treat BA -negative patients; the change of BA and the outcome of re -pregnancy after treatment were detected. Results： Under protection of 10% concentration of albumin, there was no statistically signifi- cant difference in the proportions of CD3＋ , CD3 ＋ CD8＋ and CD3 ＋ CD4＋ lymphocytes within 0 -90 days （P 〉 O. 05 ）, then the proportions decreased significantly within 120 - 180 days, there was statistically significant difference （P 〈 0. 05 ） ; BA positive rate among RSA patients was 6. 7%, after treatment, the positive rate of BA was up to 78.3%, compared with before treatment, there was statistically significant difference （P 〈 0. 05 ） ; the successful rates of re -pregnancy in BA -positive patients and BA -negative patients were 87. 2% and 33.3%, respectively, there was statistically significant difference between the two groups （P 〈 O. 05 ） . Conclusion： The 10% concentration of al- bumin has good protective effect on cryopreserved lymphocytes within a certain time （ ≤ 180 days）, these eryopreserved lymphocytes has good curative effect in treatment of RSA patients, which can relieve the pain of lymphocyte donors, reduce the pollution caused by repeat op- erations and make the process safer and more effective.

关 键 词：复发性流产 白蛋白 淋巴细胞主动免疫治疗 封闭抗体 

分 类 号：R714.21[医药卫生—妇产科学]