静脉用免疫球蛋白对不明原因复发性自然流产患者外周血淋巴细胞和妊娠结局的影响  

Effect of Intravenous Immunoglobulin on Peripheral Blood Lymphocyte Cell and Pregnancy Outcome in Women with Recurrent Spontaneous Abortion

作　　者：李玉华[1] 陈颖[2] 祝丽琼[2] 张蜀宁[2] 张建平[2] 韩立薇[1] 何小红[1] 韦成厚[1] 张碧云[1] 陈进[1] 

机构地区：[1]广东省计划生育科学技术研究所,广州510600 [2]中山大学孙逸仙纪念医院,广州510120

出　　处：《生殖与避孕》2014年第8期672-676,共5页Reproduction and Contraception

基　　金：国家卫生计生委资助项目(编号:2012-GJKJS-01);国家自然基金面上项目(编号81170625)资助项目

摘　　要：目的:评估静脉用免疫球蛋白(IVIg)治疗不明原因复发性自然流产(RSA)的效果。方法:选择既往曾发生≥3次自然流产的RSA患者65例,孕早期给予IVIg治疗,追踪至妊娠结束。检查治疗前、后外周血淋巴细胞亚群,包括自然杀伤细胞(NK细胞)、毒性T淋巴细胞、辅助性T淋巴细胞和自然杀伤T细胞(NKT细胞)的变化,进行统计学分析。结果:1经过IVIg治疗,外周血NK细胞数量/比例明显下降,差异有统计学意义(P<0.05);2治疗后,52例RSA患者成功妊娠并分娩活产,活产率达88.1%;3治疗中发生流产的患者外周血NK细胞数量明显高于分娩活产的妇女,差异有统计学意义(P<0.05)。结论:IVIg治疗不明原因RSA有比较明确的临床效果,其机制可能为通过调节患者外周血NK细胞数量/比例而发挥作用。Objective： To evaluate the efficacy of intravenous immunoglobulin （IVIg） in treating the women with recurrent spontaneous abortion （RSA）. Methods： By flowcytometric analyses, phenotypic changes of a variety of immunological cells were examined including natural killer （NK） cells, cytotoxic T cells, regulatory T cells and NKT cells in peripheral blood of RSA women with IVIg therapy （n=65）. Results： After therapy, 88.1% （52/65） patients had live birth; NK cell percentage significantly decreased after therapy （P〈0.05）. The number and the proportions of NK cells were significantly higher in patients with a subsequent abortion than in those with pregnancy to term. Conclusion： IVIg is effective in treating patients with unexplained RSA; Wig therapy may take an effect through reducing the number and the proportions of peripheral NK cells.

关 键 词：静脉用免疫球蛋白(IVIg) 复发性自然流产(RSA) 外周血 自然杀伤细胞(NK细胞) 

分 类 号：R714.21[医药卫生—妇产科学]