[父淋巴细胞免疫治疗途径及频次对复发性自然流产妇女封闭抗体阳性率的研究]

[Study on positive rate of blocking antibody in women with recurrent spontaneous abortion administered by route and frequency of paternal lymphocyte immunotherapy].

作者信息

Yu Hong-ling, Deng Xiao-hui, Chao Lan, Chen Chao, Han Yi-long

机构信息

Infertility Center, Qilu Hospital of Shandong University, Jinan 250012, China.

Infertility Center, Qilu Hospital of Shandong University, Jinan 250012, China. Email:

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2013 Dec;48(12):903-6.

PMID:24495682

Abstract

OBJECTIVE

To investigates factors affecting the positive rate of blocking antibody treated by paternal lymphocyte immunotherapy in patients with recurrent spontaneous abortion (RSA).

METHODS

From January 2008 to August 2012, 326 RSA cases undergoing treatment in Infertility Center of Qilu Hospital were studied retrospectively. Those patients were divided into 2 groups randomly: 260 cases in intradermal injection group were administered via bilateral forearm intradermal injections for immunotherapy once 21 days, then the blocking antibody was determined after 2 (23 cases) , 3(73 cases), 4 (74 cases) , 5(90 cases) times respectively, while in subcutaneous injection group, the 66 cases were administered via subcutaneous injection once 21 days, the blocking antibody measured after 3 times; In both cases, the blocking antibody was all determined 2 weeks later. The positive rate of blocking antibodies and the rate of successful pregnancy was recorded, and then followed up after the blocking antibody turning positive.

RESULTS

(1) Positive rate of blocking antibodies:the positive rate of blocking antibodies were 17% (4/23) , 58% (42/73), 72% (53/74) and 84% (76/90) in the 2, 3, 4, and 5 times of intradermal injection group, respectively (P < 0.05). In subcutaneous injection group, the positive rate of blocking antibodies was 38 % (25/66), which was significantly lower than that in group intradermal injection receiving 3 times immunotherapy (P < 0.05). (2) The rate of pregnancy:the 176 patients out of 200 patients were pregnant when antibody was positive after immunotherapy, with 71.6% (126/176) of patients gained successful pregnancy(the length of pregnancy more than 5 months).

CONCLUSIONS

The route and frequency of administration of immunotherapy could influence the positive rate of blocking antibody. The rate of successful pregnancy will be increased after blocking antibody turning positive.

摘要

目的

探讨影响父淋巴细胞免疫疗法治疗复发性自然流产（RSA）患者封闭抗体阳性率的因素。

方法

回顾性分析2008年1月至2012年8月在齐鲁医院不孕不育中心接受治疗的326例RSA患者。将这些患者随机分为2组：皮内注射组260例，通过双侧前臂皮内注射进行免疫治疗，每21天1次，分别于2次（23例）、3次（73例）、4次（74例）、5次（90例）免疫治疗后检测封闭抗体，皮下注射组66例，每21天皮下注射1次，3次免疫治疗后检测封闭抗体；两组均于免疫治疗2周后检测封闭抗体。记录封闭抗体阳性率及妊娠成功率，并在封闭抗体转阳后进行随访。

结果

（1）封闭抗体阳性率：皮内注射组2次、3次、4次、5次免疫治疗后封闭抗体阳性率分别为17%（4/23）、58%（42/73）、72%（53/74）、84%（76/90）（P<0.05）。皮下注射组封闭抗体阳性率为38%（25/66），明显低于皮内注射组3次免疫治疗后的阳性率（P<0.05）。（2）妊娠率：免疫治疗后抗体阳性的200例患者中176例妊娠，妊娠成功率为71.6%（126/176）（妊娠时间超过5个月）。