主动免疫疗法在原因不明习惯性流产患者中的应用

摘要

目的 探讨细胞免疫功能的变化与原因不明习惯性流产(UHA)的发生及主动免疫治疗机制的关系.方法 用流式细胞仪测定并比较66例UHA患者和30例健康已生育妇女(NF组)及30例主动免疫治疗后的UHA患者外周血CD3+、CD4+、CD8+、CD16+CD56+细胞亚群百分率及CD4+/CD8+的比值;同时,比较采用主动免疫治疗30例和未采用主动免疫治疗的36例UHA患者再次妊娠成功率.结果 UHA患者与NF组比较,血中CD3+、CD16+CD56+细胞的百分率及CD4+/CD8+比值增高,差异有统计学意义(P＜0.050).主动免疫后CD3+、CD16+CD56+细胞的百分率及CD4+/CD8+比值下降(P＜0.050).主动免疫治疗组的再次妊娠成功率为92.86%,未主动免疫治疗组29.03%,P＜0.001.结论 淋巴细胞亚群比例的改变与UHA的发生有关,主动免疫治疗可调节异常的细胞免疫功能,有利于再次妊娠成功率的提高.%Objective To explore the relationship between the changes in cellular immunity and the causes of unexplained habitual abortion(UHA)as well as the mechanism of active immunotherapy on UHA patients.Methods T-lymphocyte and natural killer(NK)cell subsets(CD3+%,CD4+%,CD8+%,CD16+CD56+% and CD4+/CD8+ ratio)of peripheral blood were detected by applying flow cytometry and compared in 66 cases of UHA(UHA group,including 30 cases receiving active immunotherapy and 36 untreated UHA cases)and 30 cases of healthy fertile women(healthy control group).The re-pregnancy achievement ratio was compared between 30 treated UHA cases and 36 untreated UHA cases.Results The percentages of CD31+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly higher in UHA group than those of healthy control group(P＜0.050).As compared with those of untreated UHA subgroup,the percentages of CD3+ and CD16+ CD56+ cells as well as CD4+/CD8+ ratio were significantly lower(P＜0.050),while the re-pregnancy achievement ratio was higher(92.86% vs 05 29.03%,P＜0.001).Conclusion The changes in T-lymphocyte and NK cell subsets have something to do with occurrence of UHA.Active immunotherapy can regulate the cellular immune function and improve the re-pregnancy achievement ratio effectively.