淋巴细胞免疫治疗对不孕不育患者封闭抗体的表达及再妊娠的影响-东南大学学报医学版

淋巴细胞免疫治疗对不孕不育患者封闭抗体的表达及再妊娠的影响

单位：郑州大学附属洛阳中心医院/洛阳市中心医院妇科, 郑州洛阳 471000

分类号：R711.6

出版年·卷·期（页码）：2017·36·第四期（614-619）

摘要：

目的：研究淋巴细胞免疫疗法对复发性流产患者的封闭抗体、淋巴细胞亚群及再妊娠的影响。方法：对符合条件的复发性流产患者行淋巴细胞免疫疗法，分别于治疗前后应用ELISA检测患者外周血封闭抗体的表达，免疫散射比浊法测定免疫球蛋白浓度，流式细胞仪检测患者淋巴细胞亚群数量及相关比值，并对患者进行2年的随访，统计患者妊娠或自然流产发生数。结果：淋巴细胞免疫治疗后封闭抗体阳性表达患者例数显著高于治疗前（χ²=135.67，P<0.001）；IgM和IgG免疫球蛋白的浓度显著低于治疗前（P<0.05）；治疗后的CD3⁺和CD4⁺淋巴细胞数量显著低于治疗前（P<0.05），而CD8⁺淋巴细胞数量显著高于治疗前（P<0.05），治疗后CD4⁺/CD8⁺的值较治疗前显著减小（P<0.05），治疗后CD56⁺CD16⁺NK细胞数量显著低于治疗前（P<0.05）。封闭抗体阳性者自然流产率为10.26%，封闭抗体阴性者为58.33%，差异有统计学意义（χ²=20.554，P<0.05）。结论：淋巴细胞免疫疗法具有增加患者封闭抗体表达、提高妊娠成功率的作用。

Objective:To study the effect of lymphocyte immunotherapy on the blocking antibodies, lymphocyte subsets and re-pregnancy in patients with recurrent spontaneous abortion. Methods:The patients of recurrent spontaneous abortion were treated with lymphocyte immunotherapy. The expression of the blocking antibody in peripheral blood was detected by ELISA and the concentration of immunoglobulin was determined by immunoturbidimetry scattering. The number of lymphocyte subpopulations and the ratio were detected by flow cytometry. The patients were followed up for 2 years and the number of patients with pregnancy or spontaneous abortion was recorded. Results:The positive expression number of blocking antibodies after treatment was significantly higher compared with that before treatment (χ²=135.67, P<0.001). The concentrations of IgM and IgG immunoglobulins after the treatment were significantly lower than those before treatment (P<0.05). The number of CD3⁺ and CD4⁺ lymphocytes after treatment was significantly lower than that before treatment (P<0.05), but the number of CD8⁺ lymphocytes was significantly higher than that before treatment (P<0.05). The ratio of CD4⁺/CD8+ decreased significantly (P<0.05). The number of CD56⁺CD16⁺ NK cells after treatment was significantly lower than that before treatment (P<0.05). The spontaneous abortion rate was 10.26% for positive blocking antibodies and 58.33% for negative blocking antibodies respectively, and there was a significant difference between positive and negative blocking antibodies (χ²=20.554, P<0.05). Conclusion:Lymphocyte immunotherapy can increase the expression of the blocking antibodies and increase the success of pregnancy.

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