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目的:探讨人类白细胞抗原(HLA)基因多态性对不明原因反复流产(URSA)免疫治疗疗效的预测价值。方法:①采用酶联免疫法(ELISA)测定URSA患者免疫治疗前、免疫治疗一疗程后封闭抗体(BA),并随访阳性者与阴性者的妊娠率。②采用52例封闭抗体阴性的URSA患者进行主动免疫治疗,随机抽取32例于免疫治疗前用SSP-PCR方法测定患者免疫治疗前及妊娠后血浆内的HLA-A、B、DR及G的表达率。结果:①免疫治疗后BA阳性者及阴性者的妊娠成功率差异无统计学意义,P>0.05。②HLA-G*010401及HLA*1502的表达频率在再次流产者中明显高于成功妊娠者,组间比较差异均有统计学意义(分别为P<0.01,P<0.05)。结论:HLA基因的多态性与免疫治疗妊娠结局似乎有更好的相关性,其中HLA-G*010401、HlA-DRB1*1502与免疫治疗后妊娠结局关系密切,有可能成为有价值的预测指标。
Objective: To investigate the predictive value of human leukocyte antigen (HLA) gene polymorphism in treatment of unexplained recurrent spontaneous abortion (URSA) immunotherapy. Methods: ① ELISA was used to measure the pregnancy rate of patients with URSA before immunotherapy and after one course of immunotherapy. ② Fifty-two patients with positive URSA antibody were enrolled in the study. HLA-A, B, DR and G were measured in 32 patients before and after immunotherapy by SSP-PCR before immunotherapy rate. Results ① There was no significant difference in pregnancy success rate between BA positive and negative patients after immunotherapy, P> 0.05. ② The frequencies of HLA-G * 010401 and HLA * 1502 were significantly higher in repeat abortion than in those with successful pregnancy (P <0.01, P <0.05, respectively). CONCLUSIONS: There seems to be a better correlation between HLA polymorphism and immunotherapy outcome in pregnancy, of which HLA-G * 010401 and HlA-DRB1 * 1502 are closely related to pregnancy outcome after immunotherapy and may be valuable predictors .