反复流产患者的封闭抗体治疗

An investigation of therapeutic effect of T-lymphocyte immunotherapy on recurrent spontaneous abortion

目的 观察反复流产患者的封闭抗体水平及免疫疗法治疗效果.方法 通过补体依赖细胞毒试验检测128例反复流产患者的封闭抗体水平,应用淋巴细胞疗法作免疫治疗1～3个疗程,疗程结束后复查封闭抗体水平,随访妊娠结局.结果 128例患者检出封闭抗体阴性99例,占77.3%,其均行淋巴细胞免疫疗法治疗,各疗程后,封闭抗体阳性率与治疗前比较有显著性差异（χ2分别为23.12、59.03、86.69,均P＆lt;0.05）.免疫治疗后,封闭抗体阳性者85例,妊娠成功71例,流产14例;封闭抗体阴性者14例,妊娠成功3例,流产11例.两组间妊娠成功率、流产率比较均有显著性差异（χ2分别为4.87、11.06,均P＆lt;0.05）.结论 反复流产患者的封闭抗体阴性率高,应列为必须检查项目.淋巴细胞免疫治疗对反复流产疗效显著.

Objective To investigate serum level of blocking antibodies（BA） patients with recurrent spontaneous abortion （RSA） and to evaluate therapeutic effects of T-lymphocyte immunotherapy. Methods The serum level BA of 128 patients with RSA was detected by using complement-dependent cytotoxic test. The patients with negative BA were treated with husband＇ s T-lymphocyte immunotherapy for 1 to 3 courses. After the treatment, the patient＇ s BA level was detected again and their pregnancy outcomes were followed up. Results Among 128 patients with RSA, 99 patients had negative BA （77.3%） and they received T-lymphocyte immunotherapy. After every course of treatment, the positive rate of BA was increased compared with that before treatment and the difference was significant （X2 = 23.12, 59.03, 86.69 respectively, all P 〈 0.05）. After immunotherapy, 85 patients had positive BA, of them, 74 patients obtained successful pregnancy and 14 patients aborted. Otherl4 patients had still negative BA after the treatment, of them, only 3 patients obtained successful pregnancy and 11 patients aborted. In pregnancy success rate and abortion rate, there were significant differences between the two groups （X2 =4.87, 11.06 respectively, both P 〈 0.05）. Conclusion The negative rate of BA among patients with RSA is high, so for those patients with RSA, their serum level of BA should be detected rountinely. The therapeutic effect of immunotherapy for the patients is significant.