原因不明反复自然流产不同疗程的主动免疫治疗疗效观察

The observation of curative effect in defferent periods of active immunotherapy in patients with unexplained recurrent spontaneous abortion

目的比较不明原因反复自然流产主动免疫治疗不同疗程的临床疗效。方法将160例APLA阴性患者分为3组,60例治疗组只治疗一疗程4次后妊娠,78例对照组每3周治疗1次,直至APLA转阳后妊娠;22例未治疗后直接妊娠,观察3组妊娠结局。APLA采用淋巴细胞毒实验进行检测。结果免疫治疗前APLA阳性率为8.57%,免疫治疗后治疗组、对照组APLA阳性率分别为41.67%、94.87%,治疗前后APLA比较差异显著(P<0.01)。治疗组妊娠成功率为88.64%,对照组妊娠成功率为90.77%,两组比较差异不显著(P>0.05),未治疗组妊娠成功率为43.75%,与前两组比较差异显著(P<0.01)。结论免疫治疗能有效刺激母体产生封闭抗体。对不明原因反复自然流产患者孕前进行一疗程4次治疗具有疗程短、疗效显著、妊娠结局好等特点。

Objective： To compare curative effect of the treatment of unexplained recurrent spontaneous abortion by active immunotherapy with different periods. Methods： One hundred and sixty Anti -paternal lymphocyte antibody （APLA） negative patients were divided into three groups. Sixty positive group were pregnant for four times after one therapy period. Seventy - eight control group were not pregnant until APLA changed to be positive with the treatment of one time at an interval of three weeks. 22 negative group were pregnant without treatment. Then we compare the pregnant results in the three groups. APLA were analysed by the lymphocytotoxin test. Results： The APLA positive rate was 8.57% before immunotherapy. The positive rate in the positive group and the control group was 41.67% and 94. 87%. After immunization, the APLA positive rate increased significantly （ P 〈0. 01 ）. But the positive rate was not different between the two immunotherapy groups （ P 〉 0. 05 ）, The successful pregnancy rate in the positive group was 88. 64% ; The rate in the control group was 90. 77%, The results in the two groups have no difference （ P 〉 0. 05 ）. However the successful pregnancy rate in the negative group was 43.75 %. The active immunotherapy appeared superior to the negative group （ P 〈0. 01 ）. Conclusion： The immunotherapy can effectively stimulate the maternal to produce the blocking antibodies. The positive group have the excellences of short period, significant curative effect, successful pregnancy and so on, Who have received immunotherapies for four times during one therapy period before the pregnancy.