反复着床失败患者预防性免疫治疗后妊娠结局评估  

Evaluation of pregnancy outcome of thawed transplantation after prophylactic immunotherapy in patients with repeated implantation failure

作　　者：赵捷 李小雪 葛逸盟 马彩红[1] 李蓉[1] ZHAO Jie;LI Xiao-Xue;GE Yi-Meng;MA Cai-Hong;LI Rong(Center for Reproductive Medicine,Peking University Third Hospital,Beijng 100191,China)

机构地区：[1]北京大学第三医院妇产科生殖中心,北京100191

出　　处：《中国免疫学杂志》2021年第23期2893-2899,2905,共8页Chinese Journal of Immunology

基　　金：国家自然科学基金(82071855)资助。

摘　　要：目的:比较反复着床失败(RIF)患者及患者中个别抗体异常者应用强的松+阿司匹林预防性治疗后解冻移植周期妊娠结局变化。方法:回顾性分析828例RIF的患者,根据移植前是否用强的松+阿司匹林治疗分为对照组与治疗组,同时分别筛选两组中抗核抗体(ANA)为1∶80的患者,或补体C3、C4、免疫球蛋白A、免疫球蛋白G和免疫球蛋白E检查中任一项异常的患者,比较对照组与治疗组两组间及组内亚组间冷冻移植后胚胎着床率、临床妊娠率、早期流产率和持续妊娠率的情况。结果:RIF患者中预防性治疗组的胚胎着床率、临床妊娠率和持续妊娠率数值稍有增加,早期流产率数值稍有下降,但均无显著性差异(P>0.05);此外,针对ANA 1∶80患者或者任何一个抗体阳性的患者,预防性治疗组也得出类似的结果。结论:预防性强的松+阿司匹林治疗不能显著提高包括个别抗体异常的RIF患者的解冻移植期妊娠结局,但需要加大样大量进一步研究。Objective:To compare the outcome of pregnancy during thawing transplantation cycle after prednisone and aspirin prophylactic treatment in patients with repeated implantation failure(RIF)and these patients with abnormal antibodies.Methods:828 RIF patients were retrospectively analyzed.According to whether treatment with prednisone plus aspirin before transplantation,all patients were divided into control group and treatment group,and screening of antinuclear antibodies(ANA)1∶80 patients,or abnormal one result in complement C3,complement C4,immunoglobulin A,immunoglobulin G and immunoglobulin E in two groups.Then comparing the frozen embryo implantation rate,clinical pregnancy rate,early abortion rate and persistent pregnancy rate after thawing transplantation between control group and treatment group or subgroups within two groups.Results:The embryo implantation rate,clinical pregnancy rate and persistent pregnancy rate were slightly increased in the prophylactic treatment group,and the early abortion rate was slightly decreased,but there were no significant difference between two groups(P>0.05).In addition,similar results were obtained in the prophylactic treatment group for ANA 1∶80 patients or any patients with one abnormal antibodies,and there were no significant difference also.Conclusion:Prophylactic prednisone plus aspirin does not significantly improve the pregnancy outcome of thawed transplantation in patients with recurrent implantation failure,including patients with individual antibody abnormalities,however,further studies with a large sample size are needed.

关 键 词：反复着床失败 抗核抗体 补体 免疫球蛋白 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]