免疫因素所致复发性流产的临床治疗进展

Progress in the treatment of recurrent miscarriage caused by immunological disorders

引起复发性流产（recurrent miscarriage，RM）的原因中，免疫因素约占50％～70％，主要影响30～40岁妇女。RM分为自身免疫和同种免疫两种病型，前者体内有多种自身抗体，一方面对胚胎有毒性作用，另一方面可损伤血管内皮，造成胚胎供血障碍；后者可能与母胎界面免疫耐受异常有关。目前的免疫性治疗基本是建立在免疫学假说基础上的经验性治疗，各种药物分别作用于免疫学发病机制的各个环节，最终使免疫反应向有利于维持妊娠的方向发展。现将近几年RM的免疫性治疗进展做一综述。

It is estimated that 50%-70% of recurrent miscarriages （RM）are associated with immunologic disorders that fall into two categories： autoimmune and alloimmune. In autoimmune disorders there are some autoantibodies which may lead to pregnancy loss by causing thrombosis of placental vessels and inhibiting proliferation of trophoblasts. In alloimmune response it is thought that abnormal immune interactions at the maternal-fetal interface may result in failure of embryo implantation. Immunologic therapies based on the above hypotheses are now experiential and used to reverse the immunological aberrations to maintain pregnancy. This review is to assess the effects of immunotherapy on the live birth rate in women with RM.