淋巴细胞免疫治疗对反复妊娠流产患者封闭抗体表达的影响及其临床意义

Effect of Lymphocyte Immunotherapy on the Expression of Blocking Anti-bodies in Patients with Recurrent Spontaneous Abortion and Its Clinical Significance

目的:探究淋巴细胞免疫治疗对反复性流产(recurrent spontaneous abortion,RSA)患者封闭抗体(blocking anti-bodies,BA)的表达影响及其临床意义。方法:选取2015年1月-2016年1月本院确诊为RSA患者269例,均行淋巴细胞免疫疗法。检测患者治疗前后外周血BA表达、免疫球蛋白浓度、淋巴细胞亚群数量及相关比值,患者治疗后均随访1年,记录随访期间患者妊娠情况。结果:治疗前BA阳性24例(8.92%),低于治疗后的225例(83.64%),比较差异有统计学意义(x^2=324.51,P=0.000);治疗后Ig A、Ig M、Ig G水平均低于治疗前(P<0.05);且治疗后,CD3^+、CD4^+、CD4^+/CD8^+均低于治疗前,CD8^+高于治疗前,比较差异均有统计学意义(P<0.05);BA阳性孕妇妊娠成功率为92.18%(165/179),明显高于BA阴性孕妇的60.00%(3/5),比较差异有统计学意义(x^2=6.344,P=0.012)。结论:淋巴细胞免疫治疗RSA有助于提高患者BA表达,调节患者免疫水平并增加妊娠成功率。

Objective：To explore the effect of lymphocyte immunotherapy on the expression of blocking antibodies（BA） in patients with recurrent spontaneous abortion（RSA） and its clinical significance.Method：A total of 269 patients with RSA diagnosed in our hospital from January 2015 to January 2016 were selected,they were treated with lymphocyte immunotherapy.The expression of BA,the concentration of immunoglobulin,the number of lymphocyte subsets and the relative ratio were measured before and after treatment,they were followed up for 1 year after treatment,and the pregnancy was recorded during the follow-up period.Result：Before treatment,BA positive was 24 cases（8.92%）,lower than 225 cases（83.64%） of after treatment,the difference was statistically significant（ x^2=324.51,P=0.000）.After treatment,the levels of Ig A,Ig M and Ig G were all lower than those of before treatment（P〈0.05）.After treatment,CD3~＋,CD4~＋ and CD4~＋/CD8~＋ were all lower than those of before treatment,CD8~＋ was higher than that of before treatment,the differences were statistically significant（P〈0.05）.The pregnancy rate of BA positive pregnant women was 92.18%（165/179）,which was significantly higher than 60.00%（3/5） in BA negative pregnant women,the difference was statistically significant（ x^2=6.344,P=0.012）.Conclusion：Lymphocyte immunotherapy in treatment of RSA can help improve BA expression,regulate immune function and increase pregnancy success rate.