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目的检测不明原因反复流产患者(URA)主动免疫治疗后外周血TCRγδT淋巴细胞水平的变化,探讨其在孕早期母胎免疫调节中的作用。方法中国医科大学附属第二医院于2002年3~10月对微量淋巴毒试验结果阴性的15例URA患者进行主动免疫治疗。采用流式细胞仪检测观察组治疗前后及正常早孕妇女(对照组,n=11)外周血TCRγδT淋巴细胞水平。结果(1)URA患者的T淋巴细胞总数无显著性变化(P>005),但治疗后外周血TCRγδT淋巴细胞水平较治疗前显著增高(P<001)。(2)15名患者中成功妊娠13例,妊娠成功率为846%(11/13)。(3)主动免疫治疗后成功妊娠的妇女外周血TCRγδT淋巴细胞水平与对照组相比较,差异无显著意义(P>005)。结论主动免疫治疗可以使URA患者外周血TCRγδT淋巴细胞的水平升高,提示它可能参与母胎免疫调节。
Objective To detect the level of TCRγδT lymphocytes in peripheral blood after active immunotherapy in patients with unexplained recurrent spontaneous abortion (URA), and to explore its role in the immunomodulation of maternal fetus in early pregnancy. Methods The Second Affiliated Hospital of China Medical University conducted active immunotherapy in 15 cases of URA patients negative from the results of microlymphatic lymphomas from March to October in 2002. The levels of TCRγδT lymphocytes in peripheral blood of the observation group before and after treatment and normal early pregnancy women (control group, n = 11) were detected by flow cytometry. Results (1) The total number of T lymphocytes in URA patients showed no significant change (P> 005), but the level of TCRγδT lymphocytes in peripheral blood was significantly increased after treatment (P <001). (2) Of the 15 patients, 13 had successful pregnancy, with a success rate of 846% (11/13). (3) The level of TCRγδT lymphocytes in peripheral blood of women with successful pregnancy after active immunotherapy had no significant difference (P> 005) compared with the control group. Conclusion Active immunotherapy can increase the level of TCRγδT lymphocytes in peripheral blood of patients with URA, suggesting that it may be involved in immunomodulation of the fetus.