丙种球蛋白联合淋巴细胞主动免疫治疗复发性流产的疗效

Efficacy of combined use of intravenous immune globulin and lymphocyte active immunotherapy in treatment of recurrent abortion

目的观察静脉滴注丙种球蛋白(IVIG)联合淋巴细胞主动免疫(LIT)治疗复发性流产的效果。方法原因不明性复发性流产患者90例随机均分为两组,分别采用IVIG联合LIT(联合组)和仅接受IVIG(单药组)治疗。检测治疗前后T细胞亚群(CD3^+、CD4^+和CD8^+)、IL-2和IL-10表达水平以及自然杀伤(NK)细胞含量,比较两组患者封闭抗体转阳率及临床妊娠率。结果治疗后,两组CD3^+细胞和CD8^+细胞百分比升高,CD4^+细胞百分比和CD4^+/CD8^+比值均降低,IL-2含量和NK细胞含量均降低,而IL-10含量升高(P<0.05)。联合组以上变化的幅度大于单药组(P<0.05)。治疗后,联合组封闭抗体转阳率为95.56%,高于单药组的82.22%(P<0.05),临床妊娠成功率也高于单药组(86.67%vs.64.44%)(P<0.05)。结论两种治疗方法均能有效改善患者体内免疫状态,提高妊娠成功率;IVIG联合LIT治疗较单独应用IVIG效果更好。

Objective To evaluate the efficacy of combined use of intravenous immune globulin（IVIG）and lymphocyte active immunotherapy（LIT）in treatment of recurrent abortion.Methods Ninety patients with unexplained recurrent spontaneous abortion were equally randomized into 2groups of A（treated with IVIG and LIT）and B（treated with IVIG alone）.The expression levels of lymphocyte subsets（CD3~＋,CD4~＋and CD8~＋）,IL-10 and IL-2and NK cells were detected before and after treatment.The positive rate of blocking antibody and clinical pregnancy rate were compared between two groups.Results After treatment,the percentage of CD3~＋cells and CD8~＋cells were increased,while the percentages of CD4~＋cells and CD4~＋/CD8~＋ratio were decreased significantly in two groups（P0.05）.The levels of IL-2and NK cells were significantly decreased,while IL-10 expression was increased in two groups after treatment（P0.05）.The changes were more in group A than those in group B（P0.05）.The positive rate of blocking antibody in group A was 95.56%,which was higher than 82.22% in group B（P0.05）.So did the success rate of clinical pregnancy（86.67% vs.64.44%）（P0.05）.Conclusion The two kinds of treatment can both effectively improve the immune status,increase the success rate of pregnancy in the patients with recurrent abortion,which is better if treated with IVIG and LIT than IVIG alone.