复发性流产的免疫治疗及监测分析  

Immunotherapy and monitoring analysis of recurrent miscarriage

作　　者：陈晓[1] 邓国生[1] 罗宇迪[1] 何娟[1] 文坚[1] 潘金姐 Chen Xiao;Deng Guosheng;Luo Yudi;He Juan;Wen Jian;Pan Jinjie(Yulin Maternal and Child Health-Care Hospital of Guangxi 537000)

机构地区：[1]广西玉林市妇幼保健院,537000

出　　处：《中国社区医师》2017年第29期17-18,20,共3页Chinese Community Doctors

基　　金：复发性流产的免疫治疗及监测分析,项目编号:13036023~~

摘　　要：目的:探讨不明原因复发性流产患者采用淋巴细胞主动免疫治疗的临床效果。方法:收治封闭抗体缺乏引起的复发性流产患者200例,对其进行淋巴细胞免疫治疗,观察治疗后封闭抗体的变化及妊娠结局。结果:实际追踪人数158例,其中封闭抗体未行复查74例。接受免疫治疗2次后,BA转阳9例;免疫治疗5次后,BA转阳53例。84例封闭抗体复查患者免疫治疗5次后转阳62例,转阳率73.81%。与治疗前相比,差异有统计学意义(P<0.05)。治疗的患者158例中实际追踪155例,妊娠成功82例,妊娠成功率51.90%;复查未转阳性22例,妊娠成功9例,妊娠成功率40.90%,差异有统计学意义(P<0.05)。流产次数≤3次妊娠成功率53.38%,明显高于>3次妊娠的30.00%,差异有统计学意义(P<0.05)。结论:淋巴细胞免疫治疗可提高封闭抗体的阳性率及封闭抗体阴性患者的再次妊娠成功率。流产次数>3次患者和年龄≥35岁的患者在免疫治疗的同时积极进行保胎治疗,可获得更高的妊娠成功率。Objective:To investigate the clinical efficacy of active immunotherapy with lymphocytes in unexplained recurrentspontaneous abortion.Methods:Lymphocyte immunotherapy was performed in200patients with recurrent miscarriage due to thelack of blocking antibodies(APLA).The change of blocking antibody and pregnancy outcome were observed.Results:There were158cases of actual follow-up,among whom74cases were not examined by APLA.After2times of immunotherapy,BA was turnedpositive in9cases.After5times of immunotherapy,BA was positive in53cases.Of84cases with APLA reexamination,62casesturned positive after5times,and the rate of seroconversion was73.81%;compared with before treatment,the difference wasstatistically significant(P<0.05).Among the158patients treated,155cases were followed up,82cases were successful inpregnancy,and the pregnancy success rate was51.90%,22cases were not transferred positive,9cases were successful inpregnancy,and the pregnancy success rate was40.90%,the difference was statistically significant(P<0.05).The pregnancysuccess rate of patients with the number of abortions less than or equal to3times was53.38%,which was significantly higher thanthat of more than3times of30%,and the difference was statistically significant(P<0.05).Conclusion:Lymphocyte immunotherapycan improve the positive rate of APLA and the success rate of negative pregnancy in patients with negative antibody.Abortiontimes>3times and the age of35or more in patients after immunotherapy of active tocolytic therapy at the same time,can obtain ahigher success rate of pregnancy.

关 键 词：APLA 复发性流产 RSA 淋巴细胞 免疫治疗 

分 类 号：R714.21[医药卫生—妇产科学]