CAJ | 학술논문

目的：探讨不明原因复发性流产患者采用淋巴细胞主动免疫治疗前后封闭抗体（BA）的变化及疗效，并分析流产次数、患者年龄与妊娠结局的关系。方法对89例BA阴性的不明原因复发性流产患者进行淋巴细胞主动免疫治疗，观察其治疗后BA的变化及妊娠结局。结果①患者治疗前BA检测均为阴性，接受免疫治疗3次后，BA转阳者36例（40.4%），免疫治疗6次后BA阳性42例（47.2%）。89例反复性流产患者免疫治疗6次后共转阳78例，转阳率为87.6%。与治疗前相比，差异有统计学意义（P＜0.05）；②在89例治疗的患者中，有79例获妊娠成功，10例再次发生早期流产，妊娠成功率88.76%（79/89），BA阳性患者的妊娠成功率明显高于BA阴性者，差异有统计学意义；③流产次数≤3次者治疗后妊娠成功率明显高于流产次数＞3次者（P＜0.05）；④年龄≤35岁者妊娠成功率明显高于年龄＞35岁者（P＜0.05）。结论淋巴细胞主动免疫治疗能提高BA阴性的不明原因复发性流产患者的再次妊娠成功率及提高BA的阳性率,建议连续自然流产2次或以上者及早干预治疗。
목적：탐토불명원인복발성유산환자채용림파세포주동면역치료전후봉폐항체（BA）적변화급료효，병분석유산차수、환자년령여임신결국적관계。방법대89례BA음성적불명원인복발성유산환자진행림파세포주동면역치료，관찰기치료후BA적변화급임신결국。결과①환자치료전BA검측균위음성，접수면역치료3차후，BA전양자36례（40.4%），면역치료6차후BA양성42례（47.2%）。89례반복성유산환자면역치료6차후공전양78례，전양솔위87.6%。여치료전상비，차이유통계학의의（P＜0.05）；②재89례치료적환자중，유79례획임신성공，10례재차발생조기유산，임신성공솔88.76%（79/89），BA양성환자적임신성공솔명현고우BA음성자，차이유통계학의의；③유산차수≤3차자치료후임신성공솔명현고우유산차수＞3차자（P＜0.05）；④년령≤35세자임신성공솔명현고우년령＞35세자（P＜0.05）。결론림파세포주동면역치료능제고BA음성적불명원인복발성유산환자적재차임신성공솔급제고BA적양성솔,건의련속자연유산2차혹이상자급조간예치료。
Objective To investigate the sffectiveness of lymphocyte active immunotherapy in patients with unexplained recurrent spontaneous abortion(URSA)and the changes of blocking antibody(BA)before and after the treatment and to analyze the relationship of abortion time and patients, age with the outcomes of URSA after lymphocyte active immunotherapy. Methods 89 URSA patients with negative blocking antiboies were immunized with lymphocytes. The changes of BA after the treatment and the outcome of subsequent pregnancy were observed. Results ①89 URSA patients were negative blocking antiboies before lymphocyte active immunotherapy. 36(40.4%)were positive after 3 immunization.42(47.2%)were positive after 6 immunization. The positive rate was 88.76%(79/89). ② 79 of 89 patients with the treatment were successfully conceived. The successful rate of pregnancy in positive BA was higher than that in negative BA. There was significant difference(P<0.05).③The pregnancy Success rate of abortion time less than or equal to 3 was significantly higher than that of abortion time more than 3(P<0.05).④The pregnancy success rate of age group under 35 was significantly higher than the age group above 35(P<0.05). Conclusion Lymphocyte active immunotherapy can improve the successful rate of subsequent pregnancy in blocking antibody-negative patients with URSA, and raise the positive rate of blocking antibody. URSA patients should be interfered and treated as early as possible.