McIntyre J A, Coulam C B, Faulk W P
Center for Reproduction and Transplantation Immunology, Methodist Hospital of Indiana, Indianapolis 46202.
Am J Reprod Immunol. 1989 Nov-Dec;21(3-4):100-4. doi: 10.1111/j.1600-0897.1989.tb01011.x.
The laboratory diagnosis and clinical management of unexplained recurrent spontaneous abortion (RSA) patients is a controversial issue in contemporary obstetrics. In this report, the results of laboratory investigations and immunotherapy of RSA patients referred to our Center since 1986 are detailed. Our analyses have resulted in grouping RSA patients into primary (1 degree), secondary (2 degrees), and unexplained classifications. Laboratory evaluation criteria included assays for both complement-dependent and complement-independent antipaternal antibodies as well as histocompatibility antigen tissue typing for HLA, A, B, C, and DR antigens. In addition, mixed lymphocyte cultures (MLC) were performed to assess the degree of HLA-D locus compatibility between couples and to test for the presence of MLC inhibitors in maternal blood. Immunotherapy options and the rationale for their use are given and preliminary outcome data are presented from randomized double-blinded, placebo-controlled clinical trials.
不明原因复发性自然流产（RSA）患者的实验室诊断及临床处理是当代产科领域一个颇具争议的问题。在本报告中，详细阐述了自1986年以来转诊至本中心的RSA患者的实验室检查结果及免疫治疗情况。我们的分析将RSA患者分为原发性（1级）、继发性（2级）和不明原因三类。实验室评估标准包括检测补体依赖性和非补体依赖性抗父系抗体，以及对HLA、A、B、C和DR抗原进行组织相容性抗原分型。此外，还进行了混合淋巴细胞培养（MLC），以评估夫妻间HLA - D位点的相容程度，并检测母体血液中是否存在MLC抑制剂。文中给出了免疫治疗方案及其使用原理，并呈现了随机双盲、安慰剂对照临床试验的初步结果数据。
