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目的:评估静脉用免疫球蛋白(IVIg)治疗不明原因复发性自然流产(RSA)的效果。方法:选择既往曾发生≥3次自然流产的RSA患者65例,孕早期给予IVIg治疗,追踪至妊娠结束。检查治疗前、后外周血淋巴细胞亚群,包括自然杀伤细胞(NK细胞)、毒性T淋巴细胞、辅助性T淋巴细胞和自然杀伤T细胞(NKT细胞)的变化,进行统计学分析。结果:1经过IVIg治疗,外周血NK细胞数量/比例明显下降,差异有统计学意义(P<0.05);2治疗后,52例RSA患者成功妊娠并分娩活产,活产率达88.1%;3治疗中发生流产的患者外周血NK细胞数量明显高于分娩活产的妇女,差异有统计学意义(P<0.05)。结论:IVIg治疗不明原因RSA有比较明确的临床效果,其机制可能为通过调节患者外周血NK细胞数量/比例而发挥作用。
Objective: To evaluate the effect of intravenous immunoglobulin (IVIg) in the treatment of unexplained recurrent spontaneous abortion (RSA). METHODS: Sixty-five RSA patients who had> 3 spontaneous abortions in the past were enrolled in this study. IVIg was given in the first trimester and was followed up until the end of pregnancy. The changes of peripheral blood lymphocyte subsets including natural killer cells (NK cells), T-lymphocytes, helper T-lymphocytes and natural killer T cells (NKT cells) before and after treatment were examined for statistical analysis. After treatment with IVIg, the number and ratio of NK cells in peripheral blood decreased significantly (P <0.05). After treatment, 52 patients with RSA had a successful pregnancy and childbirth with a live birth rate of 88.1%. 3 The number of NK cells in peripheral blood of patients with abortion was significantly higher than that of childbearing live births, the difference was statistically significant (P <0.05). Conclusion: The IVIg treatment of unexplained RSA has a clear clinical effect, the mechanism may be by regulating the number / proportion of NK cells in peripheral blood of patients to play a role.