龙成英+徐珊珊

[摘要]目的 研究淋巴细胞注射联合口服地屈孕酮治疗同种免疫性复发性流产的临床效果。方法 随机选择200例2015年1月～2016年1月在我院封闭抗体均为阴性的同种免疫性复发性流产患者，將其随机均分为对照组和研究组。研究组患者孕前开始接受淋巴细胞注射、妊娠后加服地屈孕酮；对照组患者孕后开始接受淋巴细胞注射联合口服地屈孕酮。同时对两组患者进行定期随访，观察两组患者的妊娠成功率、病理妊娠率。结果 经过相应的治疗后，两组患者的转阳性情况较为明显，但组间转阳性情况比较差异无统计学意义（P>0.05）。以妊娠≥12周的患者为妊娠成功，研究组的妊娠成功率（80.0%）明显高于对照组（62.0%），差异有统计学意义（χ2=17.267，P=0.018）。结论 采用孕前注射淋巴细胞、妊娠后加服地屈孕酮治疗同种免疫性复发性流产的患者，改善体内细胞免疫状态，具有较好的疗效。

[关键词]淋巴细胞注射；地屈孕酮；免疫性复发性流产

[中图分类号] R714.21 [文献标识码] A [文章编号] 1674-4721（2016）12（b）-0099-03

Clinical study of lymphocyte injection combined with oral administration of progesterone in the treatment of alloimmune recurrent abortion

LONG Cheng-ying XU Shan-shan

Renkang Hospital of Dongguan，Guangdong Province，Dongguan 523952，China

[Abstract]Objective To study the clinical effect of lymphocyte injection combined with oral administration of progesterone in the treatment of alloimmune recurrent abortion.Methods Two hundred patients were randomly selected from January 2015 to January 2016 in our hospital with negative closed antibodies for recurrent abortion and the same kind of immunity，and were randomly divided into the control group and the study group equally.The patients of the study group was given the injection of lymphocyte and when pregnancy for progesterone plus；the patients of the control group，pregnancy was given lymphocyte injection combined with oral dydrogesterone.At the same time，patients of the two groups were regularly followed up to observe with pregnancy success rate and pathological pregnancy rate.Results After the corresponding treatment，patients with the positive situation of the two groups was more obvious，but the difference between the positive and negative cases was not significant （P>0.05）.Patients with greater or equal to 12 weeks pregnancy were successful，the success rate of pregnancy of the study group （80.0%） was significantly higher than that of the control group （62.0%），the difference was statistically significant （χ2=17.267，P=0.018）.Conclusion The preinjection of lymphocytes，pregnancy plus oral dydrogesterone in the treatment of patients with alloimmune recurrent spontaneous abortion，improve the cell immune status in vivo，has good curative effect.

[Key words]Lymphocyte injection；Progesterone；Immune recurrent abortion

复发性流产（recurrent spontaneous abortion，RSA）是妇科常见的自然流产2次及2次以上的情况，发病率约占自然流产的4.0%[1]。研究表明，因免疫所引发的复发性流产约占52%，可分为自身免疫性复发性流产和同种免疫性复发性流产[2]。临床上常采用父方或第三方个体的淋巴细胞注射主动免疫治疗封闭抗体阴性复发性流产患者，人为主动地强化妊娠免疫学机制，抑制母胎间细胞的免疫排斥反应，从而降低流产率[3]。但是，不同的时间注射淋巴细胞影响患者的治疗效果，我院对此做了探究，现报道如下。 ……