CAJ | 학술논문

目的探讨复发性流产(recurrent spontaneous abortion,RSA)患者静脉滴注免疫球蛋白对其外周血NK细胞的影响.方法 2011年1月至2012年6月在我院住院的RSA患者共38例.其中18例静脉滴注免疫球蛋白(IVIG)治疗,作为研究组；20例不同意使用免疫球蛋白治疗的RSA患者作为对照组.比较两组患者外周血NK细胞毒性及NK细胞在所有淋巴细胞中的比例.结果治疗前,研究组NK细胞毒性为(22.4±7.9)％,NK细胞比例为(25.1±9.4)％；治疗后,研究组NK细胞毒性为(15.0±4.2)％,NK细胞比例为(26.2±8.7)％.第一次检测时,对照组NK细胞毒性为(21.7±8.1)％,NK细胞比例为(24.0±9.0)％；间隔10d后复测,对照组NK细胞毒性为(25.6±7.9)％,NK细胞比例为(23.6±6.8)％.静脉滴注免疫球蛋白后,研究组患者静脉外周血NK细胞毒性显著降低,差异有统计学意义(P＜ 0.05),但NK细胞的比例无显著变化,差异无统计学意义(P＞0.05).对照组的第1次与第2次外周血NK细胞毒性比较差异无统计学意义(P＞ 0.05),2次NK细胞的比例比较差异亦无统计学意义(P＞0.05).经过住院安胎治疗后,研究组妊娠时间超过24周的占88.9％(16/18),对照组超过24周的占55.0％(11/20),两组相比差异有统计学意义(P＜ 0.05).结论 RSA患者静脉滴注免疫球蛋白可降低NK细胞毒性,提高RAS患者的安胎成功率.
목적 탐토복발성유산(recurrent spontaneous abortion,RSA)환자정맥적주면역구단백대기외주혈NK세포적영향.방법 2011년1월지2012년6월재아원주원적RSA환자공38례.기중18례정맥적주면역구단백(IVIG)치료,작위연구조；20례불동의사용면역구단백치료적RSA환자작위대조조.비교량조환자외주혈NK세포독성급NK세포재소유림파세포중적비례.결과 치료전,연구조NK세포독성위(22.4±7.9)％,NK세포비례위(25.1±9.4)％；치료후,연구조NK세포독성위(15.0±4.2)％,NK세포비례위(26.2±8.7)％.제일차검측시,대조조NK세포독성위(21.7±8.1)％,NK세포비례위(24.0±9.0)％；간격10d후복측,대조조NK세포독성위(25.6±7.9)％,NK세포비례위(23.6±6.8)％.정맥적주면역구단백후,연구조환자정맥외주혈NK세포독성현저강저,차이유통계학의의(P＜ 0.05),단NK세포적비례무현저변화,차이무통계학의의(P＞0.05).대조조적제1차여제2차외주혈NK세포독성비교차이무통계학의의(P＞ 0.05),2차NK세포적비례비교차이역무통계학의의(P＞0.05).경과주원안태치료후,연구조임신시간초과24주적점88.9％(16/18),대조조초과24주적점55.0％(11/20),량조상비차이유통계학의의(P＜ 0.05).결론 RSA환자정맥적주면역구단백가강저NK세포독성,제고RAS환자적안태성공솔.
Objective To explore the impact of intravenous immunoglobulin on peripheral blood natural killer (NK) cells in women with recurrent spontaneous abortion (RSA).Methods Of 38 patients with RSA who had been hospitalized during the period of January 2011 to June 2012,18 patients received intravenous immunoglobulin (study group) while the rest 20 who refused to receive immunoglobulin were assigned to a control group.Peripheral NK cell cytotoxicity and rate of NK cells in all types of lymphocytes were detected before and after treatment by flow cytometry.Results NK cell cytotoxicity was(22.4 + 7.9)％ in the study group and (21.7 ± 8.1)％ in the control group before treatment,was (15.0 ± 4.2)％ in the study group and (25.6 ± 7.9)％ in the control group after treatment.Before treatment,the rate of NK cell was (25.1 ± 9.4) ％ in the study group and (24.0 ± 9.0) ％ in the control group,while after treatment it was (26.2 ± 8.7) ％ in the study group and (23.6 ± 6.8) ％ in the control group.NK cell c.vtotoxicity but not the rate of NK cell was significantly reduced (P＜0.05) in the study group.After treatment,NK cell cytotoxicity and the rate of NK cell did not differ significantly (P＞0.05).88.9％ of the patients in the study group but 55.0％ of the patients in the control group had pregnancy duration of longer than 24 weeks after tocolytic treatment (P＜0.05).Conclusions Intravenous immunoglobulin can reduce NK cell cytotoxicity,leading to an increase in the success rate of miscarriage prevention in patients with recurrent spontaneous abortion.