【摘要】 目的:探讨不明原因反复流产(URSA)患者采用淋巴细胞免疫治疗后妊娠结局。方法:将在该院生殖医学中心就诊临床确诊为URSA且自身抗体及封闭抗体阴性的115例患者采用丈夫或无关第三者外周血淋巴细胞皮内注射法进行孕前、孕后免疫治疗,观察并分析其妊娠结局。结果:采用淋巴细胞免疫治疗后的妊娠成功率高于常规的保胎治疗;封闭抗体转阳性者妊娠成功率也高于仍阴性者,存在统计学差异(P<0.01);年龄>35岁者妊娠成功率明显低于年龄<35岁者(P<0.01);孕前治疗3次以上和3次以下者妊娠成功率比较无统计学差异(P>0.05);但孕后治疗3次以上者较3次以下者有更高的妊娠成功率(P<0.01)。结论:对URSA患者采用淋巴细胞免疫治疗法治疗较常规黄体酮+地屈孕酮保胎治疗获得更高妊娠成功率;对于年龄>35岁者建议采取免疫治疗结合常规保胎治疗;免疫治疗3次后尽快指导妊娠,孕后至少治疗3次以上效果更理想。更多还原

【Abstract】 Objective: To explore the pregnancy outcome of 115 cases with unexplained recurrent spontaneous abortion( URSA)treated by lymphocyte immunotherapy. Methods: Progestational and gestational immunotherapy were conducted among 115 cases diagnosed as URSA definitely in Center for Reproductive Medicine in the hospital by intradermic injection of lymphocytes in peripheral blood of their husbands or third- party peripheral blood,the autoantibody and blocking antibody of the cases were negative; the pregnancy outcome was observed and analyzed. Results: The successful rate of pregnancy after lymphocyte immunotherapy was higher than that of routine fetus protection; the successful rate of pregnancy among the cases with positive conversion of blocking antibody was statistically significantly higher than that still with negative blocking antibody( P < 0. 01); the successful rate of pregnancy among the cases more than 35 years was statistically significantly lower than that less than 35 years( P < 0. 01); there was no statistically significant difference in the successful rate of pregnancy between the cases treated for more than three times before pregnancy and the cases treated for less than three times before pregnancy( P > 0. 05); the successful rate of pregnancy among the cases treated for more than three times after pregnancy was statistically significantly higher than that treated for less than three times after pregnancy( P <0. 01). Conclusion: The successful rate of pregnancy among URSA cases treated by lymphocyte immunotherapy is higher than that treated by routine progesterone combined with dydrogesterone for fetus protection; for the cases more than 35 years old,immunotherapy combined with routine fetus protection is recommended; pregnancy should be guided as soon as possible after immunotherapy for three times,the effect of gestational immunotherapy for more than three times is better.更多还原