免疫型复发性流产患者血清封闭抗体、TPOAb及ANA的临床治疗变化

Changes in clinical treatment of serum blocking antibody,TPOAb and ANA in patients with immune recurrent spontaneous abortion

目的探讨免疫型复发性流产患者血清封闭抗体、TPOAb及ANA的临床治疗变化。方法选取2018年1月至2021年12月收治于赣州市妇幼保健院的106例免疫型RSA患者作为研究对象,按随机数字表法分为对照组和观察组,各53例。对照组予以主动免疫治疗,观察组在对照组的基础上联合金水宝胶囊治疗,两组均治疗3个月。统计分析两组妊娠结局、规范用药所需时间及不良反应发生率;对比两组治疗前、治3个月后自然杀伤(NK)细胞(CD56^(+))、B细胞(CD19^(+))百分比、血清封闭抗体水平[CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]水平、甲状腺过氧化物酶抗体(TPOAb)阳性率及抗核抗体(ANA)阳性率。结果治疗3个月后,观察组足月分娩率高于对照组(P<0.05);两组规范用药所需时间差异无统计学意义(P>0.05)。两组CD56^(+)、CD19^(+)百分比、TPOAb及ANA阳性率均降低,且观察组低于对照组(P<0.05)。两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均降低,CD8^(+)均升高,且观察组血清封闭抗体水平均优于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P<0.05)。结论金水宝胶囊治疗免疫型复发性流产临床疗效显著,能调节血清封闭抗体、TPOAb及ANA的表达水平,适宜作为免疫型复发性流产的理想治疗方案。

Objective To investigate the clinical treatment changes of serum blocking antibodies,TPOAb and ANA in patients with immune recurrent spontaneous abortion.Methods A total of 106 immune⁃type RSA patients admitted to Ganzhou Maternal and Child Health Hospital from January 2018 to December 2021 were selected as the research subjects,and divided into the control group and the observation group according to random number table method,with 53 cases in each group.The control group was given active immunotherapy,and the observation group was treated with Jinshuibao Capsule on the basis of the control group,both groups were treated for 3 months.Statistical analysis of pregnancy outcomes,time required for standardized medication and incidence of adverse reactions between the two groups was performed.Comparison of the percentages of natural killer(NK)cells(CD56^(+)),B cells(CD19^(+))and serum blocking antibody levels before and after 3 months of treatment between the two groups[CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)]levels,positive rate of thyroid peroxidase antibody(TPOAb)and positive rate of antinuclear antibody(ANA)were carried out.Results After 3 months of treatment,the full⁃term delivery rate in the observation group was higher than that in the control group(P<0.05).There was no significant difference in the time required for standardized medication between the two groups(P>0.05).The percentages of CD56^(+),CD19^(+),TPOAb and ANA in both groups were decreased,and the observation group was lower than the control group(P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the two groups were decreased,and CD8^(+)was increased,and the serum blocking antibody level in the observation group was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion Jinshuibao Capsules has a significant clinical effect in the treatment of immune⁃type recurrent abortion,and can regulate the expression levels of serum blocking antibodies,TPOAb and ANA,and is suitable as an ideal treatment for immune⁃type recurrent abortion.