环孢素A联合淋巴细胞主动免疫对URSA患者血清T细胞亚群、激素水平及ACA抗体水平的影响

Effects of cyclosporine A combined with active lymphocyte immunotherapy on serum T cell subsets,hormone levels and ACA levels in patients with URSA

目的探究环孢素A(CsA)联合淋巴细胞主动免疫(LIT)对原因不明复发性流产(URSA)患者血清T细胞亚群、激素水平及抗心磷脂抗体(ACA)水平的影响。方法选取我科2017年10月-2019年10月期间87例URSA患者,根据随机数字表法分组。基础治疗采用低分子肝素钙,对照组43例给予LIT治疗,观察组44例增加CsA治疗,对比两组患者血清T细胞亚群:CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+);激素水平:血清人绒毛膜促性腺激素(HCG)、孕激素(P)、雌二醇(E2);ACA抗体(ACA-IgM、ACA-IgG)水平;不良反应;妊娠结局。结果治疗后观察组CD8^(+)、ACA-IgM、ACA-IgG水平、早期流产率低于对照组,CD3^(+)、CD4^(+)、CD4^(^(+))/CD8^(+)、HCG、P、E2水平、临床妊娠率高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率11.36%高于对照组9.30%,差异无统计学意义(P>0.05)。结论CsA联合LIT治疗URSA患者,可有效改善免疫功能,提高孕激素水平,降低ACA抗体水平,药物安全性高,提升妊娠率。

Objective To explore the effect of cyclosporin A(CsA)combined with active lymphocyte immunotherapy(LIT)on serum T cell subsets,hormone levels and anticardiolipin antibody(ACA)levels in patients with unexplained recurrent spontaneous abortion(URSA).Methods A total of 87 URSA patients visiting our department from October 2017 to October 2019 were selected and grouped according to the random number table.Low-molecular-weight heparin calcium was used as basic treatment.The control group(n=43)were treated with LIT,and the observation group(n=44)were treated with CsA com bined with LIT.We compared the serum T cell subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),hormone levels[serum human chorionic gonadotropin(HCG),progesterone(P)and estradiol(E2)],ACA levels(ACA-IgM,ACA-IgG),adverse reactions and pregnancy outcomes between two groups.Results After treatment,the observation group had lower levels of CD8^(+),ACA-IgM,ACA-IgG and early abortion rate and higer levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),HCG,P,E2 and clinical pregnancy rate than the control group,with statistically significant differences(P<0.05).The incidence of adverse reactions of the observation group(11.36%)was higher than that of the control group(9.30%),showing no statistically significant difference(P>0.05).Conclusion The combination of CsA and LIT can effectively improve the immune function,increase progesterone levels and reduce ACA antibody levels.It can enhance the safety of the drug and pregnancy rate in the treatment of URSA patients.