Sterzik K, Strehler E, De Santo M, Oblinger E, Rosenbusch B, Kreienberg R
Abt. Frauenheilkunde und Geburtshilfe, Universität Ulm.
Geburtshilfe Frauenheilkd. 1995 Sep;55(9):493-9. doi: 10.1055/s-2007-1022827.
The effect of lymphocyte transfusions on the stabilisation and successful outcome of pregnancy was investigated in 30 women with recurrent abortions presumably caused by immunologic factors. Lymphocyte concentrates were obtained from stored whole blood of the husbands and transferred by intravenous injection. Exclusion criteria for this study were the presence of antipaternal lymphocytotoxic antibodies in the patient's serum (cross match) or an advanced pregnancy (> 12 weeks). After transfusion of paternal lymphocytes 19 (63%) women had uncomplicated and successful pregnancies whereas 11 (37%) suffered again from early pregnancy loss. Two out of these 11 patients aborted twice. The probability of a successful treatment decreased as soon as lymphocytotoxic antibodies appeared in the patient's serum (p < or = 0.021). Women with a lower number of abortions before treatment carried their pregnancies to full term more frequently (p < or = 0.03). The number of transfusions, the period between start of treatment and conception as well as the distribution of age within the two groups had no significant effect on the outcome of therapy. A lack of lymphocytotoxic antibodies or their late appearance during treatment give a positive prognosis for the progress of pregnancy. Compared with a fertile control group, couples with habitual abortions showed no significantly increased HLA sharing. Immunisation with paternal lymphocytes in cases of presumably habitual abortions due to immunologic factors appears as an effective therapy with only few side effects. Large, randomised, double-blind, and placebo-controlled trials are needed before drawing conclusions.
在30名可能由免疫因素导致反复流产的女性中，研究了淋巴细胞输注对妊娠稳定及成功结局的影响。淋巴细胞浓缩物取自丈夫储存的全血，并通过静脉注射进行输注。本研究的排除标准为患者血清中存在抗父本淋巴细胞毒性抗体（交叉配型）或妊娠进展至晚期（>12周）。输注父本淋巴细胞后，19名（63%）女性妊娠过程顺利且成功，而11名（37%）女性再次发生早期妊娠丢失。这11名患者中有2人流产两次。一旦患者血清中出现淋巴细胞毒性抗体，成功治疗的概率就会降低（p≤0.021）。治疗前流产次数较少的女性更频繁地将妊娠维持至足月（p≤0.03）。输注次数、治疗开始至受孕的时间间隔以及两组的年龄分布对治疗结局均无显著影响。缺乏淋巴细胞毒性抗体或其在治疗期间较晚出现提示妊娠进展预后良好。与可生育对照组相比，习惯性流产夫妇的HLA共享率无显著增加。对于可能因免疫因素导致习惯性流产的病例，用父本淋巴细胞进行免疫似乎是一种有效的治疗方法，且副作用较少。在得出结论之前，需要进行大规模、随机、双盲和安慰剂对照试验。
