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目的观察主动免疫治疗不明原因复发性流产的疗效。方法对143例不明原因复发性流产患者采取主动免疫治疗,观察其治疗后封闭抗体(BA)和淋巴细胞亚群的变化及再次妊娠的结局。结果 (1)临床妊娠成功112例,再次早期流产5例,26未受孕,妊娠成功率78.3%;(2)主动免疫治疗后复查,115例BA转阳性,阳性率80.4%。阳性率与治疗前比较差异有高度统计学意义(P<0.01)。(3)主动免疫治疗后CD3+细胞无变化,CD4+细胞、CD4+/CD8+比值较治疗前明显下降,CD8+细胞则明显升高(均P<0.01)。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,并可调节异常的细胞的免疫功能,有利于再次妊娠成功率的提高。
Objective To observe the effect of active immunotherapy on unexplained recurrent spontaneous abortion. Methods In 143 patients with unexplained recurrent spontaneous abortion, we took active immunotherapy and observed the change of blocking antibody (BA) and lymphocyte subsets and the outcome of re-pregnancy after treatment. Results (1) The clinical pregnancy was successful in 112 cases, again in the early abortion in 5 cases, 26 without pregnancy, pregnancy success rate of 78.3%; (2) active immunization after review, 115 cases of BA positive, the positive rate of 80.4%. There was a significant difference between the positive rate and before treatment (P <0.01). (3) There was no change in CD3 + cells after active immunization. The ratio of CD4 + cells and CD4 + / CD8 + decreased significantly compared with those before treatment, and CD8 + cells increased significantly (all P <0.01). Conclusion Active immunotherapy with lymphocytes can increase the success rate of pregnancy again and increase the positive rate of BA in patients with BA-negative unexplained recurrent spontaneous abortion, and can regulate the immune function of abnormal cells, which is conducive to the success rate of pregnancy again.