封闭抗体阴性复发性流产患者应用常规保胎联合免疫球蛋白被动免疫治疗的疗效观察  

Clinical efficacy of conventional tocolytic therapy combined with passive immunoglobulin immunotherapy in blocking antibody-negative recurrent spontaneous abortion patients

作　　者：林晓岚 林清兰 陈丽华 黄丽娟 LIN Xiaolan;LIN Qinglan;CHEN Lihua;HUANG Lijuan(Department of Obstetrics and Gynecology,the Affiliated Xiaolan Hospital,Southern Medical University,Zhongshan 528415,Guangdong Province,China)

机构地区：[1]南方医科大学附属小榄医院妇产科,广东中山528415

出　　处：《西南医科大学学报》2021年第2期154-158,共5页Journal of Southwest Medical University

摘　　要：目的:观察封闭抗体阴性的复发性流产患者应用常规保胎治疗联合免疫球蛋白被动免疫治疗的临床疗效。方法:选取2018年1月至2019年4月来本院就诊的(recurrent spontaneous sbortion,RSA)早孕保胎患者共108例,分为对照组和观察组。对照组采用常规保胎治疗,观察组在对照组的基础上添加丙种免疫球蛋白被动免疫治疗。治疗期间监测两组患者孕6、8和11周的血清β-HCG及孕酮水平,定期进行B超检查,监测胚胎发育情况,比较两组患者治疗前后CD19~+、自然杀伤(NK)细胞、CD3~+、CD4~+及CD8~+细胞水平变化,比较两组患者妊娠成功率及不良反应发生率。结果:在妊娠的第6、8和11周,观察组患者血清β-HCG及孕酮水平均显著高于对照组患者(P <0.05)。对两组患者治疗前后CD19~+、NK细胞、CD3~+、CD4~+及CD8~+水平之差进行检测,对照组患者治疗前后CD19~+、NK细胞、CD3~+、CD4~+及CD8~+水平变化均明显低于观察组患者(P <0.05)。对照组患者妊娠成功率为44.44%,观察组患者妊娠成功率达81.48%,观察组妊娠成功率高于对照组,差异有统计学意义(P <0.05)。对照组患者发生不良反应共13例,发生率为24.07%,观察组患者发生不良反应共14例,发生率为25.93%,与对照组相比,差异无统计学差异(P> 0.05)。结论:常规保胎治疗联合丙种免疫球蛋白被动免疫治疗能够提高封闭抗体阴性的RAS患者妊娠成功率,改善其相关免疫指标,可作为临床治疗的有效手段。Objective:To evaluate the clinical efficacy of conventional tocolytic therapy combined with passive immunoglobulin immunotherapy in blocking antibody(BA)-negative recurrent spontaneous abortion(RSA)patients.Methods:A total of 108 RSA patients in early pregnancy who were admitted to our hospital from January 2018 to April 2019 were randomly divided into control group and observation group.The control group was treated with con⁃ventional tocolytic therapy,and the observation group was given conventional tocolytic therapy plus passive immuno⁃globulin immunotherapy.Post-treatment serumβ-HCG and progesterone levels were monitored at weeks 6,8,and 11 of pregnancy in the two groups.Ultrasound was performed regularly to monitor embryo development.Changes in the percentages of CD19+,NK,CD3+,CD4+,and CD8+cells after treatment were examined and compared between the two groups.Pregnancy success rate and adverse reaction rate were compared between the two groups.Results:At weeks 6,8,and 11 of pregnancy,serumβ-HCG and progesterone levels were significantly higher in the observation group than in the control group(P<0.05).The changes in the percentages of CD19+,NK,CD3+,CD4+,and CD8+cells after treatment were significantly lower in the control group than in the observation group(P<0.05)(Table 2).The pregnancy success rate was significantly higher in the observation group than in the control group(81.48%vs 44.44%,P<0.05).However,there was no significant difference in the adverse reaction rate between the control group(13 cases,24.07%)and the observation group(14 cases,25.93%)(P>0.05).Conclusion:Conventional toco⁃lytic therapy combined with passive immunoglobulin immunotherapy can improve the pregnancy success rate and im⁃mune parameters of BA-negative RSA patients,and may therefore be an effective clinical treatment for RAS.

关 键 词：复发性流产 封闭抗体阴性 丙种免疫球蛋白 

分 类 号：R714.21[医药卫生—妇产科学]