母牛分枝杆菌联合泼尼松治疗女性抗精子抗体阳性免疫性不孕

Mycobacterium vaccae combined with prednisone in the treatment of positive immune infertility in female with antisperm antibody

目的探讨母牛分歧杆菌与泼尼松联合治疗女性抗精子抗体(AsAb)阳性免疫性不孕的临床效果。方法选取2014年7月至2016年6月本院收治的AsAb阳性免疫性不孕患者80例为研究对象,以随机数字表法分为对照组和观察组各40例。对照组给予泼尼松治疗,观察组在对照组基础上联合母牛分枝杆菌治疗,观察两组患者血清AsAb水平变化、AsAb转阴率、1年后妊娠率及不良反应发生情况。结果治疗前两组患者血清AsAb水平差异无统计学意义(P>0.05),治疗后均有下降,观察组治疗后1、3个月AsAb水平明显低于对照组,差异有统计学意义(P<0.05);观察组AsAb转阴率及1年后妊娠率分别为95.00%、62.50%,对照组为75.00%、40.00%,差异有统计学意义(P<0.05);观察组不良反应发生率为12.50%,同对照组10.00%相比,差异无统计学意义(P>0.05),两组均未出现严重不良反应。结论应用母牛分枝杆菌联合泼尼松治疗AsAb阳性免疫性不孕,可显著降低AsAb水平,提高患者妊娠概率,且安全性高,值得推广。

Objective To investigate the clinical efficacy of mycobacterium vaccine combined with prednisone in the treatment of positive immune infertility in female with antisperm antibody(AsAb).Methods A total of 80 cases of patients with AsAb positive immunity infertility treated in our hospital from July 2014 to June 2016 were selected as the research objects and randomly divided into the control group and the observation group with 40 cases in each group.The patients in the control group were given prednisone treatment while patients in the observation group were treated with mycobacterium vaccine combined with prednisone.The changes of serum AsAb level,AsAb negative rate,pregnancy rate and adverse reactions after 1 year were observed in the two groups.Results There was no significant difference in serum AsAb levels between the two groups before treatment(P>0.05),but they decreased after treatment.The levels of AsAb in the observation group in the first month and the third month after treatment were significantly lower than those of the control group and the difference was statistically significant(P<0.05).The negative rate of AsAb and the rate of pregnancy after 1 year were respectively 95.00%and 62.50%,and compared with 75.00%and 40.00%in control group,the difference was statisti cally significant(P<0.05).The incidence of adverse reactions in observation group was 12.50%,but compared with 10.00%in control group,the difference was not statistically significant(P>0.05).There were no serious adverse reactions in the two groups.Conclusion The application of the combination of mycobacterium and prednisone in the treatment of positive immune infertility in female with AsAb can significantly reduce the level of AsAb,increase the pregnancy probability,and have high safety,which is worthy of promotion.