王欣，李培旭

(解放军150医院妇产科，洛阳 471003)



封闭抗体阴性的反复自然流产患者采用配偶淋巴细胞主动免疫治疗效果观察

王欣，李培旭*

(解放军150医院妇产科，洛阳 471003)

目的 观察配偶淋巴细胞主动免疫治疗封闭抗体阴性的反复自然流产的效果。 方法 收集2010年1月至2015年1月于我院行封闭抗体阴性的经治疗后获得首次妊娠的反复自然流产患者97例，依据不同治疗方法分为研究组76例和对照组21例。研究组采用丈夫外周血淋巴细胞主动免疫治疗后观察封闭抗体的变化，对照组采用小剂量免疫抑制剂等治疗，比较两组治疗后首次妊娠的结局。 结果 研究组76例孕妇，妊娠成功51例，妊娠成功率67.11%；对照组21例孕妇，妊娠成功8例，妊娠成功率38.10%。研究组妊娠成功率显著高于对照组妊娠成功率(P<0.05)。研究组76例免疫治疗后复查封闭抗体，27例转阳性孕妇19例妊娠成功，妊娠成功率70.37%，49例仍阴性孕妇32例妊娠成功，妊娠成功率为65.31%；两者比较妊娠成功率差异无统计学意义(P>0.05)。 结论 免疫治疗可显著提高反复自然流产患者的妊娠成功率，封闭抗体转阳只是其纷繁复杂的机理之一。

反复自然流产； 封闭抗体； 免疫治疗

Methods：The data of 97 patients with recurrent spontaneous abortion & negative anti-paternal lymphocyte antibody who received their first pregnancy in our hospital from Jan.2010 to Jan.2015 were collected.The patients were divided to two groups：the patients in the study group were treated with paternal lymphocyte(n=76)，and the patients in control group were treated with small doses of immunosuppressants(n=21).The first pregnant outcomes were compared between the two groups.

Results：The pregnancy rate(67.11% vs.38.10%)of the study group is significantly higher than that of the control group(P<0.05).In the studying group，the pregnancy rate(70.37%)in 27 patients whose APLA turned positive was higher than that(65.31%)in 49 patients whose APLA was still negative after immunotherapy(P>0.05).

Conclusions：The pregnancy rate is significantly increased after immunotherapy with paternal lymphocyte；but the results are not always consistent with the changes in APLA.

(JReprodMed2016，25(11)：998-1001)

自然流产是指妊娠20周以前或者胎儿体重小于450克，或在获得有生机儿之前的自然流产或胚胎宫内停止发育；反复自然流产(RSA)是指连续2次及以上发生自然流产[1]。收集我院近5年因反复自然流产就诊、经临床检查排除生殖器官器质性病变、染色体异常、黄体功能不足、动静血栓前状态等，封闭抗体(APLA)检测结果为阴性、经过小剂量免疫抑制剂治疗或者丈夫外周血淋巴细胞免疫治疗(immunotherapy)后获得首次妊娠的患者97例，根据治疗方法不同分为两组：研究组(76例)采用配偶淋巴细胞主动免疫治疗；……