叶酸联合主动免疫治疗不明原因复发性流产95例

95 Cases of Folic Acid Combining with Active Immunotherapy in the Treatment of Unexplained Recurrent Spontaneous Abortion

目的探讨对不明原因复发性流产患者采用大剂量叶酸联合主动免疫的临床疗效。方法对就诊的不明原因复发性流产患者95例,随机分成A组(49例)及B组(46例),分别采用叶酸5 mg及0.4 mg,两组均联合配偶淋巴细胞免疫治疗,随访其妊娠结局。结果 A组共妊娠49例,其中足月分娩15例(30.61%);尚在妊娠中32例,其中≥20周者30例(61.22%),<20周者2例(4.08%);再次自然流产2例(4.08%);妊娠成功率91.84%,所出生婴儿发育正常。B组共妊娠45例,其中足月分娩12例(26.09%);尚在妊娠中29例,其中≥20周者21例(45.65%),<20周者8例(17.39%),其中因胎儿脊柱裂孕19周引产1例;再次自然流产4例(8.89%);妊娠成功率71.74%。A组比B组有较高的妊娠成功率(P<0.025)。结论大剂量叶酸联合主动免疫治疗URSA的疗效肯定,治疗后妊娠成功率高,胎儿畸形率低。

Objective To investigate the effect of high dose folic acid with active immunotherapy in the treatment of habitual premature labor.Methods 96 women with URSA were enrolled in Heze Munipal Hospital between January 2010 and June 2012. They were randomly divided into A group （49 cases）or B group （46 cases）. A group received 5mg folic acid and were injected lymphocytes seperated from the peripheral blood of their spouses.By contrast, B group received 0.4mg folic acid and treated with active immunotherapy. Pregnancy outcome were assessed. Results Among A group, 49 cases were conceived, and 15 cases （30.61%） full-term delivered（born babies were normal）, 32 cases were still in the process of pregnancy, and 30 cases （61.22%）were beyond 20 weeks pregnancy, and 2 cases （4.08%）were within 20 weeks pregnancy, and 2 cases （4.08%）underwent spontaneous abortion once again. The rate of success was 91.84%. Among B group, 45 cases were conceived, and 12 cases（26.09%） full-term delivered, 29 cases were still in the process of pregnancy, and 21cases （46.65%）were beyond 20 weeks pregnancy, and 8cases （17.39%）were within 20 weeks pregnancy （one of these cases was induced abortion at 19 weeks because of spina bifida）, and 4 cases （8.89%）underwent spontaneous abortion once again. The rate of success was 71.74%.The A group＇ s success rate was high than that of B group （P〈 0.025）. Conclusions High dose folic acid combining with active immunotherapy is an effective treatment for the URSA.The rate of success was high and the rate of fetal malformation was low.