主动免疫疗法对原因不明复发性流产的防治及妊娠结局的影响

Preventive Treatment of Unexplained Recurrent Spontaneous Abortion and Effect on Pregnancy Outcomes by Active Immunotherapy

目的:探讨淋巴细胞主动免疫疗法对原因不明复发性流产的防治及妊娠结局的影响。方法:将900例原因不明复发性流产患者随机分为治疗组与西药对照组、中药对照组,每组各300例。治疗组给予淋巴细胞主动免疫治疗,西药对照组给予地屈孕酮片,每次10mg,每日3次;中药对照组口服速效保胎灵片,每次3片,每日3次。结果:治疗后各组孕65 d及孕12周胎儿存活率分别为治疗组88.9%、84.2%,西药对照组58.3%、46.1%,中药对照组51.7%、40.1%,治疗组与两对照组比较,差异均有统计学意义(P<0.05);孕65 d及孕12周流产率分别为治疗组11.1%、15.8%,西药对照组41.7%、53.9%,中药对照组48.2%、59.9%,治疗组与两对照组比较,差异均有统计学意义(P<0.05);治疗组IL-4及IL-6水平升高、IFN-γ及IL-2水平下降明显,与两对照组比较,差异均有统计学意义(P<0.05)。结论:淋巴细胞主动免疫治疗可通过调节Th1型免疫应答向Th2型转换,增强原因不明复发性流产患者的免疫耐受,明显降低流产率,提高胎儿存活率,为原因不明复发性流产的有效治疗手段。

Objective：To explore preventive treatment of unexplained recurrent spontaneous abortion and effect on pregnancy outcomes by lymphatic cells active immunotherapy.Methods：900 patients with unexplained recurrent spontaneous abortion were randomly divided into treatment group and western medicine control group,Chinese medicine control group,300 cases in each group.The treatment group was given lymphatic cells active immunotherapy,and western medicine control group was treated with Dydrogesterone Tablets,10 mg each time,3 times a day,and Chinese medicine control group was given Suxiao Baotailing Tablets,3 pieces each time,3 times a day.Results：After treatment,fetal survival rates of 65 days and 12 weeks after pregnancy in each group respectively were 88.9%,84.2% in the treatment group,58.3%,46.1% in the western medicine control group,and 51.7%,40.1% in the Chinese medicine control group.Comparisons of the treatment group and two control groups showed that the differences were statistically significant（P0.05）.Abortion rates of 65 days and 12 weeks after pregnancy in each group respectively were 11.1%,15.8% in the treatment group,41.7%,53.9% in the western medicine control group,and 48.2%,59.9% in the Chinese medicine control group,and the differences of the treatment group and two control groups had statistical significance（P0.05）.The treatment group had elevated levels of IL-4 and IL-6,significantly descending levels of IFN-γ and IL-2,compared with two control groups showed that the differences had statistical significance（P0.05）.Conclusion：Lymphocytes active immunotherapy can enhance immune tolerance in patients with unexplained recurrent spontaneous abortion,reduce abortion rate significantly,improve fetal survival rate by regulating conversion of Th1 type immune response to Th2 type,which is the effective treatment of unexplained recurrent spontaneous abortion.