反复自然流产患者淋巴细胞主动免疫的治疗效果及其与HLA相关性研究
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摘要
目的观察淋巴细胞主动免疫治疗反复自然流产的临床效果,分析封闭抗体转阳与夫妻双方人类白细胞分化抗原(HLA)相容性的关系。方法选取2013年10月至2016年10月在福建省妇幼保健院遗传与优生门诊就诊,临床诊断为封闭抗体缺乏所致的反复自然流产,从而接受丈夫淋巴细胞主动免疫治疗的患者73例,同时检测患者夫妻双方HLA相容性,随访并分析其妊娠结局。结果接受免疫治疗的73例患者中,49例封闭抗体转阳,转阳率为67.12%(49/73),49例封闭抗体转阳患者中成功妊娠45例,24例封闭抗体未转阳患者中成功妊娠6例,因此接受主动免疫治疗总体妊娠成功率为69.86%(51/73)。49例封闭抗体转阳的患者中47例夫妻双方HLA相容性低,24例封闭抗体未转阳的患者中21例夫妻双方HLA相容性高。结论淋巴细胞主动免疫治疗对反复自然流产有效,夫妻双方HLA相容性与封闭抗体转阳有相关性。
Objective To observe the role of lymphocyte active immunotherapy in recurrent spontaneous abortion patients, and to analyze the correlation between blocking antibody turning to positive and human lymphocyte antigen(HLA) compatibility. Methods Seventy-three patients with repeated spontaneous abortion caused by antibody deficiency who were receiving lymphocyte active immunotherapy from October 2013 to October 2016 in our hospital were enrolled in the study. HLA compatibility of couples was detected, and the patients were followed up to analyze the pregnancy outcome. Results The blocking antibody turned positive in 49 of the 73 patients who received lymphocyte active immunotherapy(67.12%, 49/73), and 45 of the 49 patients had successful pregnancy. Six of 24 patients with blocking antibody still negative had successful pregnancy. The overall successful pregnancy rate was 69.86%(51/73). Among the 49 patients with blocking antibody turning positive, 47 had low HLA compatibility with their husbands, and 21 of 24 patients with blocking antibody negative had high compatibility with their husbands. Conclusion Lymphocyte active immunotherapy has significant effect on recurrent spontaneous abortion patients, and HLA is relevant to turning positive of antibody.
Objective To observe the role of lymphocyte active immunotherapy in recurrent spontaneous abortion patients, and to analyze the correlation between blocking antibody turning to positive and human lymphocyte antigen(HLA) compatibility. Methods Seventy-three patients with repeated spontaneous abortion caused by antibody deficiency who were receiving lymphocyte active immunotherapy from October 2013 to October 2016 in our hospital were enrolled in the study. HLA compatibility of couples was detected, and the patients were followed up to analyze the pregnancy outcome. Results The blocking antibody turned positive in 49 of the 73 patients who received lymphocyte active immunotherapy(67.12%, 49/73), and 45 of the 49 patients had successful pregnancy. Six of 24 patients with blocking antibody still negative had successful pregnancy. The overall successful pregnancy rate was 69.86%(51/73). Among the 49 patients with blocking antibody turning positive, 47 had low HLA compatibility with their husbands, and 21 of 24 patients with blocking antibody negative had high compatibility with their husbands. Conclusion Lymphocyte active immunotherapy has significant effect on recurrent spontaneous abortion patients, and HLA is relevant to turning positive of antibody.
引文
[1]路鸿艳,宋海波,崔艳国.不明原因反复性自然流产的免疫学病因及治疗[J].中国优生与遗传杂志,2009,17(3):129-131.
[2]汪丹,李伟莉,等.封闭抗体与反复自然流产的研究进展[J].中国优生与遗传杂志,2009,17(11):124-125.
[3]余江,张进.封闭抗体在自然反复流产中的作用[J].中华妇产科杂志,2000,35(4):248-249.
[4]陈雪黎,米新玉,李尚为,等.原因不明习惯性流产的HLA免疫治疗分析[J].中国输血杂志,2009,22(7):565-566.
[5]孙玉梅,张庆安.应用丈夫或无关个体淋巴细胞对原因不明性习惯性流产的主动免疫治疗[J].河北医学,2003,9(5):432-433.
[6]周毅,周敏.反复性自然流产与淋巴细胞主动免疫治疗进展[J].实用妇产科杂志,2003,19(2):84-85.
[7]丁克文,刘娟,刘联斌,等.CD4+CD25+调节性T细胞和自介素10在反复自然流产中的作用探索[J].实验与检验医学,2007,25(6):531-532.
[8]杨素娟,江静,郝桂敏,等.主动免疫治疗原因不明习惯性流产的临床研究[J].实用妇产科杂志,2007,23(5):300-302.
[9]Beydoun H,Saftlas AF,et al.Association of human leucocyte antigen sharing with recurrent spontaneous abortions[J].Tissue Antigens,2005,65(2):123-135.
[10]李萍,彭倩.反复自然流产的病因学研究[J].中国实用妇科与产科杂志,2000,16(7):419-421.
[11]温泰芳,李晓红,杨乙,等.淋巴细胞注射治疗习惯性流产的分析[J].海南医学院学报,2008,14(4):352-353.
[2]汪丹,李伟莉,等.封闭抗体与反复自然流产的研究进展[J].中国优生与遗传杂志,2009,17(11):124-125.
[3]余江,张进.封闭抗体在自然反复流产中的作用[J].中华妇产科杂志,2000,35(4):248-249.
[4]陈雪黎,米新玉,李尚为,等.原因不明习惯性流产的HLA免疫治疗分析[J].中国输血杂志,2009,22(7):565-566.
[5]孙玉梅,张庆安.应用丈夫或无关个体淋巴细胞对原因不明性习惯性流产的主动免疫治疗[J].河北医学,2003,9(5):432-433.
[6]周毅,周敏.反复性自然流产与淋巴细胞主动免疫治疗进展[J].实用妇产科杂志,2003,19(2):84-85.
[7]丁克文,刘娟,刘联斌,等.CD4+CD25+调节性T细胞和自介素10在反复自然流产中的作用探索[J].实验与检验医学,2007,25(6):531-532.
[8]杨素娟,江静,郝桂敏,等.主动免疫治疗原因不明习惯性流产的临床研究[J].实用妇产科杂志,2007,23(5):300-302.
[9]Beydoun H,Saftlas AF,et al.Association of human leucocyte antigen sharing with recurrent spontaneous abortions[J].Tissue Antigens,2005,65(2):123-135.
[10]李萍,彭倩.反复自然流产的病因学研究[J].中国实用妇科与产科杂志,2000,16(7):419-421.
[11]温泰芳,李晓红,杨乙,等.淋巴细胞注射治疗习惯性流产的分析[J].海南医学院学报,2008,14(4):352-353.