主动免疫治疗原因不明习惯性流产的临床研究

Clinical Study of Active Immunotherapy in the Treatment of Unexplained Habitual Abortion

目的：探讨主动免疫治疗原因不明习惯性流产（UHA）患者的效果。方法：2001年2月至2005年10月在我院就诊的UHA患者223例作为研究对象。取其丈夫外周静脉血20ml，分离淋巴细胞后于孕前、孕后注射于患者前臂，使之产生主动免疫。随访其妊娠结局。结果：共妊娠196例（87.9％），其中足月分娩150例（67.3％）；目前尚在妊娠中23例（10.3％）：再次自然流产23例（10．3％）；未受孕27例（12．1％）。年龄33-38岁者流产率明显高于32岁以下者（P〈0.05）；孕后免疫治疗2—3次者比孕后未治疗或仅治疗1次者有较高的足月分娩率（P〈0．05），且孕后治疗1次者流产率明显升高（P〈0．05）。结论：主动免疫治疗UHA的疗效肯定，治疗后妊娠成功率高。对于年龄33岁以上患者建议早期保胎治疗；免疫治疗后3个月内受孕，孕后再治疗2次或2次以上较为理想。

Objective：To investigate the effect of active immunotherapy on unexplained habitual abortion （UHA）. Mothods：223 cases of UHA were taken into the study, Lymphocytes separated from the peripheral blood of their spouses were injected into their forearms to induce active immunization. Pregnancy outcomes were assessed. Resuits：Among the 223 cases, 196 cases were conceived（87.9%）, and 150 cases（67.3%） delivered full-termly, 23 cases（10 . 3% ） underwent spontaneous abortion once again, 23 cases （10.3%） were still in the process of pregnancy, and 27 cases（12.1%） were infertile. The abortion rate was significantly higher （P〈0.05） if the age of the patient exceeded 33 years, and if the patient received only one time immunotherapy alter conception. The rate of full-term delivery was lower （P〈0.05） in the patients who received no or only one time immunotherapy after conception. Conclusions： Active irrwnunization can improve the pregnancy meinterance in UHA patients. Managements to support pregnancy are preferred to those whose ages surpass 33 years, At least twice immunotherapies are recafter conception.