复发性流产免疫学相关因素研究进展

Advances in immunological related factors of recurrent abortion

免疫因素在复发性流产(recurrent spontaneous abortion,RSA)中起着极其重要的作用,在RSA研究领域免疫因素越来越受到重视,本研究探讨导致RSA的免疫学病因,探索新的治疗方法,对于提高RSA患者妊娠成功率、改善母婴结局意义重大。应用PubMed和中国知网期刊全文数据库检索系统,以'复发性流产'和'免疫因素'等为关键词,检索2010-01-01-2018-12-31相关文献,共检索到英文文献358篇,中文文献45篇。纳入标准:(1)复发性流产基本资料介绍。(2)免疫性复发性流产分型。(3)免疫因素复发性流产不同病理变化。根据纳入的标准,最后纳入34篇高度相关的文献进行分析综述。结果表明,免疫性流产可分为2种。自身免疫型包括组织非特异性自身抗体产生(如抗磷脂抗体、狼疮凝血因子、抗核抗体、抗DNA抗体等)和组织特异性自身抗体产生(如抗精子抗体、抗子宫内膜抗体、抗甲状腺抗体等);同种免疫型包括固有免疫紊乱(如自然杀伤细胞及补体系统异常等)和获得性免疫紊乱(封闭抗体缺乏、辅助性T淋巴细胞异常等)。深入研究免疫因素在复发性流产中的作用,可以加深对复发性流产发病机制的认识,探索新的治疗方法改善母婴结局。

Immune factors play an important role in recurrent spontaneous abortion(RSA).More and more attention has been paid to immune factors in the field of RSA.This study explores the immunological causes of RSA and explores new treatment methods.It is of great significance to improve the pregnancy success rate and maternal and infant outcomes of RSA patients.PubMed and CNKI full-text database retrieval system were used to retrieve 358 articles in English and45 articles in Chinese from January 2010 to December 2018 with the keywords of recurrent abortion,immune factors and so on.Inclusion criteria included:(1)Introduction of basic information on recurrent abortion.(2)Classification of immune recurrent abortion.(3)Different pathological changes of recurrent abortion caused by immune factors.According to the inclusion criteria,34 papers were included for analysis and summary.The results showed that there were two types of immune abortion.The autoimmune type included tissue-specific autoantibody production(such as anti-phospholipid antibody,lupus coagulation factor,anti-nuclear antibody,anti-DNA antibody,etc.)and tissue-specific autoantibody production(such as anti-sperm antibody,anti-endometrial antibody,anti-thyroid antibody,etc.).The homoimmune type included inherent immune disorders(such as abnormal natural killer cells and complement system)and acquired immune disorders(lack of blocking antibodies,abnormal helper T lymphocyte,etc.).Understanding the role of immune factors in RSA can deepen the understanding of the pathogenesis of recurrent abortion and explore new treatment methods to improve maternal and infant outcomes.