Karl M, Seewald H J, Metzner G, Tilch G, Karl A, Born U, Heilmann J
Klinik für Frauenheilkunde und Geburtshilfe, Friedrich-Schiller-Universität Jena.
Z Geburtshilfe Perinatol. 1988 Jul-Aug;192(4):147-54.
In a multicenter study we have evaluated the effect of immunotherapy with pooled buffy coats on women with habitual abortions. 21 women were selected under the same criteria with respect to clinical, immunological and blood banking conditions. All women have had at least two miscarriages with the same partner and no living child (except one case). Additionally, all well-known reasons for abortions were excluded. The couples were tested for HLA-A, B and C antigens as well as for the presence of HLA-antibodies. The couples with recurrent spontaneous abortions suggested a significantly higher compatibility in two or more antigens in comparison to the control couples with children and without any abortion. Before treatment there was no case with cytotoxic HLA antibodies. 10 women received each two pooled buffy coats intravenously before pregnancy at time intervals of 3 weeks. 15 women were treated in early pregnancy until the 28th week of gestation at the same application intervals. In the meantime 10 of 15 women have delivered at term a healthy and mature child with normal weight. Four of 15 are still pregnant in the third trimester of pregnancy. In one case the pregnancy resulted in an abortion. The buffy coat transfusions were well tolerated and led in no case to the formation of antierythrocytic antibodies. 12 of 21 women treated developed HLA antibodies at various time intervals during immunotherapy, mainly with a low titre. In 7 of 10 cases the antibodies occurred in the treatment period before pregnancy, in 5 of 15 cases during pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)
在一项多中心研究中,我们评估了用混合血沉棕黄层进行免疫疗法对习惯性流产女性的影响。根据临床、免疫学和血库条件方面的相同标准,选取了21名女性。所有女性与同一伴侣至少有过两次流产,且没有存活子女(有一例除外)。此外,排除了所有已知的流产原因。对这些夫妇进行了HLA - A、B和C抗原检测以及HLA抗体检测。与有子女且无流产史的对照夫妇相比,反复自然流产的夫妇在两种或更多种抗原上的相容性显著更高。治疗前没有细胞毒性HLA抗体的病例。10名女性在怀孕前每隔3周静脉输注两次混合血沉棕黄层。15名女性在孕早期至妊娠28周期间以相同的输注间隔接受治疗。在此期间,15名女性中有10名足月产下了健康、成熟且体重正常的婴儿。15名中有4名仍处于妊娠晚期。有一例妊娠以流产告终。血沉棕黄层输血耐受性良好,无一例导致抗红细胞抗体形成。接受治疗的21名女性中有12名在免疫治疗期间的不同时间出现了HLA抗体,主要是低滴度。10例中有7例抗体出现在怀孕前的治疗期,15例中有5例出现在孕期。(摘要截选至250字)