论文部分内容阅读
目的:探讨脂肪乳替代免疫球蛋白在自然杀伤(NK)细胞升高致复发性流产(RSA)孕妇中的临床应用。方法:回顾性分析在我中心接受治疗的283例排除其他因素确诊是NK细胞升高导致的RSA孕妇,所有患者均按常规进行保胎治疗,在孕4周末确诊为NK细胞升高后按照患者意愿选择添加免疫球蛋白(IVIG)治疗(IVIG组,n=92),或添加脂肪乳治疗(脂肪乳组,n=103),另有88例不同意使用IVIG或脂肪乳治疗者作为对照组,比较各组孕4周末和孕12周的外周血NK细胞比例及临床妊娠率差异。结果:静脉滴注IVIG或脂肪乳后(孕12周),患者静脉外周血NK细胞比例(分别为15.38±3.85%、16.10±4.05%)较对照组(21.30±4.62%)降低,而临床妊娠率(分别为81.52%、78.64%)较对照组(45.45%)高,差异均有统计学意义(P<0.05),而2个添加治疗组间妊娠成功率无统计学差异(P>0.05)。结论:IVIG和脂肪乳均可降低RSA患者静脉外周血NK细胞比例,提高临床妊娠率,且两者疗效相当。
Objective: To investigate the clinical application of lipid emulsion instead of immunoglobulin in pregnant women with recurrent spontaneous abortion (RSA) induced by natural killer (NK) cells. Methods: A retrospective analysis of 283 cases treated in our center to exclude other factors confirmed the rise of NK cells caused by RSA pregnant women, all patients were routine miscarriage treatment, 4 weeks pregnant at the end of the diagnosis of NK cells increased in patients with Intend to add IVIG treatment (IVIG group, n = 92), or add fat emulsion treatment (fat emulsion group, n = 103), and another 88 patients who did not agree to use IVIG or fat emulsion as a control group . The differences of the proportion of NK cells in peripheral blood and clinical pregnancy rate between the 4 groups at the end of pregnancy and 12 weeks of pregnancy were compared. Results: The ratio of NK cells in peripheral venous blood of IVIG patients (15.38 ± 3.85%, 16.10 ± 4.05%, respectively) was lower than that of control group (21.30 ± 4.62%) after intravenous infusion of IVIG or fat emulsion (12 weeks pregnant) (P <0.05). However, there was no significant difference in the success rate of pregnancy among the two treatment groups (P> 0.05), but the difference was statistically significant (P> 0.05) . Conclusion: Both IVIG and fat emulsion can reduce the proportion of NK cells in peripheral blood of RSA patients and improve the clinical pregnancy rate, and the curative effect is similar between the two groups.