反复自然流产患者免疫治疗前后封闭抗体的变化及其意义

Changes and significance of APLA for RSA before and after lymphocyte immunotherapy

目的:观察淋巴细胞免疫治疗反复自然流产(RSA)的效果,探讨免疫治疗前后封闭抗体(APLA)的变化及其对妊娠结局的意义。方法:用酶联免疫法(ELISA)测定988例RSA患者的APLA水平,选取其中941例APLA阴性者进行淋巴细胞免疫治疗,疗程结束后复查APLA。结果:988例RSA患者免疫治疗前APLA阳性率为4.76%(47/988),941例APLA阴性者免疫治疗一个疗程后,APLA阳性率为75.98%(715/941),2个疗程后APLA阳性率为95.96%(903/941),与治疗前比较差异有显著性(P<0.01);免疫治疗后,再次妊娠的成功率为94.07%(856/910),其中APLA阳性者再次妊娠的成功率为94.96%(848/893),APLA阴性者再次妊娠的成功率为47.06%(8/17),两者比较差异有显著性(P<0.01)。结论:淋巴细胞主动免疫治疗能提高RSA患者APLA的阳性率及再次妊娠的成功率,APLA对预计再次妊娠的结局有良好的参考价值。

Objective：To study the changes and significance of APLA for RSA before and after lymphocyte immunotherapy.Methods：The APLA in 988 RSA was detected with ELISA.A number of 941 out of the 988 RSA with negative reaction were treated with lymphocyte immunotherapy,and then the APLA was determined with ELISA.Results：The positive rate of APLA in 988 RSA was 4.76%（47/988） before lymphocyte immunotherapy.The positive rate of APLA in 941 with negative reaction was 75.98%（715/941） with one course of treatment,and then the positive rate of APLA was 95.96%（903/941） after two courses of treatment.The positive rate before was significantly different from that after lymphocyte immunotherapy（P〈0.01）.The achievement ratio of re-enceinte was 94.07%（856/910） with one or two courses of treatment of lymphocyte immunotherapy,and the achievement ratio of re-enceinte with positive APLA was 94.96%（848/893）.The achievement ratio of re-enceinte with negative APLA was 47.06%（8/17）（P〈0.01）.Conclusion：The lymphocyte immunotherapy can promote APLA positive rate and re-gestation in RSA. Recurrent spontaneous