109例淋巴细胞免疫治疗对反复性自然流产的治疗效果及妊娠结局分析

Analysis on Pregnancy Outcome of 109 Cases with Recurrent Spontaneous Abortion Treated by Lymphocyte Immunotherapy

目的探讨应用淋巴细胞免疫治疗方法对反复性自然流产患者临床治疗效果,并分析其与妊振结局的关系。方法对109例BA抗体阴性的反复性自然流产患者注射器配偶的淋巴细胞进行免疫治疗,观察治疗后BA抗体的阳转情况及与妊振结局的关系,分析流产次数,年龄与妊娠结局的关系。结果患者接受淋巴细胞免疫治疗3次后,BA出现阳转的患者73例(67%),免疫治疗6次后BA出现阳转的患者97例(98.2%)。97例BA阳转患者妊娠成功率为91.8%(89/97),12例患者BA仍阴性,仅5例患者妊娠成功,妊娠成功率为41.7%(5/12),二者相比,差异有统计学意义(P<0.05);流产次数≤2次患者治疗后妊振成功率为91%,2<流产次数≤5患者妊娠成功率为78.6%,二者相比,差异有统计学意义(P<0.05);患者年龄≤35岁时妊振成功率要明显高于年龄>35岁的患者(P<0.05)。结论淋巴细胞免疫治疗能提高反复性自然流产患者BA的阳转率,提高反复性自然流产患者再次妊振成功率,患者应该在流产2次后尽早确诊治疗,以进一步提高妊娠成功率。

Objective To explore the pregnancy outcome of 109 cases with recurrent spontaneous abortion （RSA） trea- ted by lymphocyte immunotherapy. Methods Lymphocyte immunotherapy were conducted among 109 cases diagnosed as RSA definitely by intradermic injection of lymphocytes in peripheral blood of their husbands, the changes of BA after the treatment,abortion times, ages and the outcome of subsequent pregnancy were observed and analyzed. Results 109 cases were negtive blocking antibodies before lymphocyteimmunotherapy. 73 （ 67% ） cases were positive after 3 immunization. 24 （22%） cases were positive after 6 immunization. The positive rate was 98. 2% （97）. The successful rate of pregnancy in positive BA was 91.8 % （89/97） and the successful rate of pregnancy in negtive BA was 41.7% （5/12）. There was signifi- cant difference （P 〈 0. 05 ） between that in positive BA and that in negtive BA. The pregnancy success rate of abortion time less than or equal to 2 was higher than that of abortion time more than 2 （91% vs 78. 6% ,P 〈0. 05） . The pregnancy suc- cessful rate of age under 30 and 30-35 was significantly higher than the age group above 35 （91.2% vs 68. 2,90. 6% vs 68.2,P 〈 0. 05） . Conclusion The lymphocyte immunotherapy can improve BA positive conversion rate and the successful rate of subsequent pregnancy in RSA patients. RSA patients should be diagnosed and treated as soon as possible.