反复流产患者的主动免疫治疗及其免疫调节机制初探

Active immunotherapy in RSA patients and the exploration to immunologic regulation

目的探讨反复流产(RSA)患者主动免疫治疗的疗效,及其与体内抗微淋巴细胞毒抗体(APCA)和T细胞亚群(TH1TH2)的关系。方法对50例RSA患者进行APCA检测,并对APCA阴性者主动免疫治疗,测定治疗前后的APCA水平和用酶联免疫吸附法检测TH1(IL-2、IFN-γ)和TH2(IL-4)细胞因子水平。结果RSA患者中APCA阴性者占78%,显著高于对照组(P<0.05),主动免疫后RSA患者体内APCA水平显著高于治疗前(P<0.05),和对照组水平相近;经主动免疫治疗后妊娠成功率为71.19%,新生儿健康。结论RSA患者体内存在低水平的APCA和TH1/TH2平衡失常;主动免疫可有效提高APCA水平和纠正TH1/TH2平衡失常,提高母胎免疫耐受,防止流产。

Objective：To investigate the effects of active immunotherapy on recurrent spontaneous abortion（RSA） and the relationships with APCA and T cell sub-group（TH1 and TH2）.Methods： Peripheral bloods of 50 cases RSA patients were measured to study wether they had low APCA level and the cases with low APCA level were immunized with her husbands＇lymphocytes for 4 times.APCA and T cell sub-group（IL-2,IFN-γ,IL-4）were tested before and after active immunization.Results： APCA negative rate of RSA cases was 78% before immunization,significantly higher than that of the control group（P〈0.05）;The level of IL-2 and IFN-γ were significantly lower than those before therapy（P〈0.05）,the level of IL-4 was significantly higher than that before therapy（P〈0.05）,and had no difference with those of control group（P〉0.05）.71.79% cases achieved pregnancy and newborns were normal.Conclusion：RSA patients have low level APCA and disorder balance of TH1/TH2.Active immunotherapy may increase APCA level and change the disorder balance of TH1/TH2 to prevent abortion.