左旋18甲基炔诺酮皮下埋植避孕剂对机体细胞免疫功能的影响

Study on the effect of subcutaneous implants containing levonorgestrel on immune function

探讨左旋 1 8甲基炔诺酮皮下埋植避孕剂 (皮埋剂 )对机体细胞免疫功能的影响。对应用皮埋剂妇女 1 59例 (观察组 )及 3 1名对照组妇女 ,采用改良的碱性磷酸酶抗碱性磷酸酶桥联酶标染色技术 (APAAP) ,测定 T细胞总数及亚群 ;红细胞 C3 b受体花环试验 ,测定红细胞膜补体受体 (RBC-CR)活性 ;红细胞免疫复合物花环试验 ,测定红细胞膜粘附免疫复合物 (IC)能力的大小 ;直向肿瘤红细胞花环试验 ,测定红细胞免疫粘附肿瘤细胞的能力。结果显示 ,不同埋植时间妇女 CD3、CD4、CD8及 CD4 /CD8细胞比值 ,观察组与对照组相比 ,差异无显著性意义 (P>0 .0 5) ;埋植时间为 0 .5～年的妇女 ,两组相比 ,RBC-CR花环率差异具有显著性意义 (P<0 .0 5) ;IC花环率差异具有非常显著性意义 (P<0 .0 1 ) ;其它埋植时间妇女红细胞的各项免疫指标与对照组接近 (P>0 .0 5)。认为 ,该皮埋剂不影响 T细胞总数及亚群的功能 ;红细胞免疫功能在早期可呈一过性增强 ,在中后期恢复正常并保持稳定。其原因可能是由于药物的直接作用和阴道出血引起的局部感染刺激所致 ,因此 ,该埋植剂长期应用是安全的。

Objective:To study the effect of subcutaneous implants containing levonorgestrel on T cell subsets and immune function of red cell Subjects:159 women using subcutaneous implants containing levonorgestrel, and 31 women as contral were studied. Methods:T cell subsets were detected with alkaline phosphatase anti alkaline phosphatase (APAAP) technique. Immune function of red cell were measured in erythrocyte C3b receptor rosette test (RBC C3bRR) erythrocyte immune complex rosette test (RBC ICR) and direct tumor erythrocyte rosette test. Results: It was found that the CD3、CD4、CD8 cell and CD4/CD8 ratio showed no significant difference between treatment subjects and the controls ( P >0.05). The rates of RBC C3bRR, RBC ICR in women using implants for 0.5～ years were significantly higher than normal controls ( P <0 05, P <0.01). The immune function of red cell in women with other durations had no significant difference ( P >0.05). Conclusion: Subcutaneous implants containing levonorgestrel had no effect on T cell subsets. Immune function of red cell was temporarily higher. The possible reason may be the direct effection of drug and the stimulation of local inflammation caused by vaginal hemorrhage.