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1、淋巴细胞主动免疫治疗复发性流产40例临床分析【摘要】目的:探讨采用淋巴细胞主动免疫治疗复发性流产(RSA)的临床疗效。方法:将临床筛查确诊为封闭抗体缺乏所致的复发性流产患者80例随机分为治疗组和对照组各40例,治疗组采用其配偶外周血淋巴细胞进行主动免疫治疗(LIT),对照组采用传统保胎治疗(黄体酮加hCG),比较两组的妊娠结局。结果:治疗组妊娠成功32例,成功率为80%,其中足月分娩16例(50%),妊娠中晚期16例,8例流产;对照组妊娠成功16例,成功率为40%,其中足月分娩6例(37.5%),妊娠中晚期10例,24例流产,两组比较差异有统计学意义(P〈0・01)。两组患者免疫治疗
2、的结果为,封闭抗体转为阳性患者34例,其中妊娠成功率为85.3%(29例);封闭抗体为阴性者6例,妊娠成功率为33.3%(2例),两组比较差异有统计学意义(P〈0.05)。结论:淋巴细胞主动免疫治疗复发性流产安全、有效,具有可靠的临床应用价值。【关键词】封闭抗体;复发性流产;淋巴细胞;免疫治疗【Abstract]Objective:Toinvestigatetheclinicalefficacyofrecurrentspontaneousabortion(RSA)usinglymphocytesactiveimmunotherapy.Method:80casesofpatientsw
3、ithRSAwhichwerediagnosedbyblockingantibodyscreeningwererandomlydividedintothetreatmentgroup(40patients)andthecontrolgroup(40patients).ThepatientsinthetreatmentgroupweretreatedbyLITwithperipheralbloodlymphocytes,thepatientsinthecontrolgroupwithtraditionalmiscarriagetreatment(progesteroneplushCG)
4、,thenthepregnancyoutcomeswerecomp且red.Result:Inthetreatment.group,32casesofpregnancyweretreatedsuccessfully,andthesuccessratewas80%,including16patientswithfull-termdelivery(50%),16caseswithlatepregnancy,8casesofabortion.Inthecontrolgroup,therewere16caseswithsuccessfulpregnancy,thesuccessratewas
5、40%,includingsixcaseswithtermbirth(37.5%),10caseswithlatepregnancy,24casesofabortion.Bycomparison,therewassignificantdifferenceinthetwogroups(P<0.01)・Afterimmunotherapy,34patientsbecamepositiveblockingantibodies,including29casesofpregnancysuccess,asuccessrateof85.3%;sixcasesofblockingantibodies
6、werestillnegative,twocaseswithpregnancysuccess,thesuccessratewas33.3%,respectively,thedifferencetherewasstatisticallysignificant(P<0.05)•Conelusion:LymphocyteactiveimmunotherapywhichisusedtotreatRSAissafe,effective,andreliableclinicalvalue・【Keywords】Blockingantibodies;Recurrentspontaneousaborti
7、on;Lymphocytes;Tmmunotherapy复发性流产(Recurrent.SpontaneousAbortion,RSA)患者往往经历了多次妊娠后的自然流产(连续或不连续流产次数±2次)[1]。是一种常见的妊娠期并发症,发生率占育龄妇女的1%〜5%。RSA可有单一病因或多病因引发,英病因复杂性较高,已知引起复发性流产的常见原因有:染色体异常、生殖系统机能紊乱及结构畸形、内分泌失调、妇科感染筹,此外应强调,近年来发现封闭抗体缺乏也会导致RSA。