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免疫妊娠中毒症:“原发性”妊娠高血压综合征的一种新病因概念,特别考虑初产妇;一项临床研究的初步报告

Immunogestosis: a new etiologic concept of "essential" EPH gestosis, with special consideration of the primigravid patient; preliminary report of a clinical study.

作者信息

Marti J J, Herrmann U

出版信息

Am J Obstet Gynecol. 1977 Jul 1;128(5):489-93. doi: 10.1016/0002-9378(77)90030-8.

Abstract

Evidence for immunologic processes taking part in the pathogenesis of what until now has been called the "essential" form of EPH gestosis is cited. The name of immunogestosis (IG) is introduced. The data of this preliminary study suggest that regular "inoculation" of the female genital tract with allogeneic spermatozoal histocompatibility antigens reduces the incidence of IG. Information about preconceptional sexual habits and contraceptive measures was obtained from 83 selected primigravid patients. Twenty-eight women had mild to moderate IG (Group B);55 did not (Group A). Women in Group B had had less contact with spermatozoa of partners than did women in Group A. Oral contraceptive consumption was less in Group B than in Group A. Women in Group B were younger than women in Group A. All these differences were statistically significant. A new immunoetiologic hypothesis referring to IG, as well as the theoretic and clinical implications arising from it, are discussed. This hypothesis is based on the assumption that spermatozoal histocompatibility antigens can either induce immunologic tolerance or be responsible for the phenomenon of immunologic enhancement in the maternal immunosystem. As the fetus inherits paternal histocompatibility antigens, it is concluded that pre-existing tolerance (or enhancement) exerts an IG-preventive function in a subsequent pregnancy.

摘要

文中引用了免疫过程参与到迄今为止被称为EPH妊娠中毒症“原发性”形式发病机制的证据。引入了免疫妊娠中毒症(IG)这一名称。这项初步研究的数据表明,用同种异体精子组织相容性抗原定期“接种”女性生殖道可降低IG的发病率。从83名选定的初产妇中获取了孕前性行为习惯和避孕措施的信息。28名女性患有轻度至中度IG(B组);55名女性未患病(A组)。B组女性与伴侣精子的接触比A组女性少。B组口服避孕药的使用量比A组少。B组女性比A组女性年轻。所有这些差异均具有统计学意义。讨论了一种关于IG的新免疫病因学假说及其产生的理论和临床意义。该假说基于这样的假设,即精子组织相容性抗原要么诱导免疫耐受,要么导致母体免疫系统中的免疫增强现象。由于胎儿继承了父系组织相容性抗原,因此得出结论,预先存在的耐受性(或增强作用)在随后的妊娠中发挥着预防IG的功能。

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