HLA主动免疫治疗原因不明反复自然流产92例分析

HLA Active Specific Immunotherapy for Unexplained Recurrent Spontaneous Abortion:An Analysis of 92 Cases

目的观察HLA主动免疫治疗原因不明反复自然流产(URSA)的疗效。方法对92例URSA患者用丈夫淋巴细胞进行前臂内侧皮内注射,注射分6～8点进行,每2周治疗1次,3次为1个疗程。对于HLA-DR抗体复查阴性者加强免疫治疗1～2个疗程,确认宫内妊娠后加强免疫治疗1～2个疗程。结果经HLA主动免疫治疗1个疗程后HLA-DR抗体转阳者58例,转阳率为94%。经过2个疗程治疗后HLA-DR抗体转阳者21例,转阳率为78%。92例URSA患者最终成功妊娠85例,成功率达92%。结论 HLA主动免疫疗法可有效提高HLA-DR抗体阴性URSA患者妊娠成功率,HLA-DR抗体检测可作为习惯性流产临床诊断和免疫治疗的指标之一。

Obiective To assess the therapy effect of HLA active specific immunotherapy for unexplained recurrent spontaneous abortion （URSA）. Methods The intradermal injection of their husbands＇ leukomouocyte was given to 92 cases of URSA once two weeks,with 3 times as a therapy course, one to two therapy courses of the strengthened immune treatment was given to those with negative results of HLA-DR an- tibody test and one to two therapy courses of the strengthened immune treatment was given to those whose intrauterine pregnancy was con- firmed. Results In 92 cases,58 cases showed HLA-DR antibody positive after one course of HLA active therapy,with the positive conversion rate of 94% ,and 21 cases showed the positive results of HLA-DR antibody after two course of HLA active therapy,and the positive conversion rate of 78% ,and 85 of 92 cases of URSA showed successful pregnancy after HLA active immunotherapy,with the achievement rate of 92%. Conclusion HLA active specific immunotherapy may increase the pregnancy rate of URSA cases with negative HLA-DR antibody. HLA-DR antibody can be a useful marker for the diagnosis and immunotherapy of URSA.