發(fā)布時(shí)間：2018-01-16 22:09

  本文關(guān)鍵詞：人類(lèi)白細(xì)胞抗原分型在淋巴細(xì)胞主動(dòng)免疫治療不明原因復(fù)發(fā)性流產(chǎn)中的價(jià)值研究　出處：《中國(guó)實(shí)用婦科與產(chǎn)科雜志》2016年06期 　論文類(lèi)型：期刊論文

  更多相關(guān)文章： 不明原因復(fù)發(fā)性流產(chǎn) 人類(lèi)白細(xì)胞抗原 淋巴細(xì)胞主動(dòng)免疫治療 封閉抗體

【摘要】：目的探討人類(lèi)白細(xì)胞抗原(HLA)-DR/DQ分型在免疫治療不明原因復(fù)發(fā)性流產(chǎn)(URSA)中的價(jià)值。方法選擇2013年5月至2015年3月在華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院確診為URSA、封閉抗體(BA)為陰性的患者243例,根據(jù)患者治療前是否檢測(cè)自身及供血者的HLA-DR/DQ分型,分為觀(guān)察組130例(HLA相容位點(diǎn)≤1個(gè)為A組107例,相容位點(diǎn)有2個(gè)為B組23例)和對(duì)照組113例(治療前未檢測(cè)患者及供血者的HLA-DR/DQ分型)。比較各組治療后的BA陽(yáng)性率及成功妊娠率,用多因素非條件Logistic回歸進(jìn)行相關(guān)因素分析。結(jié)果 A組BA陽(yáng)性率及成功妊娠率分別高于對(duì)照組及B組,對(duì)照組BA陽(yáng)性率及成功妊娠率高于B組(均P0.05)。在A組中選擇與患者有0或1個(gè)HLA相容位點(diǎn)的供血者,患者治療后,成功妊娠率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)�；颊吣挲g35歲時(shí),觀(guān)察組成功妊娠率明顯高于對(duì)照組(P0.05)。選擇配偶或第三方供血,患者治療后,成功妊娠率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。Logistic回歸分析顯示年齡是主動(dòng)免疫治療后BA陽(yáng)性及成功妊娠的獨(dú)立影響因素。結(jié)論 HLA-DR/DQ分型可提高URSA患者免疫治療后BA陽(yáng)性率及成功妊娠率。
[Abstract]:Objective to investigate the application of HLA-DRR / DQ typing of human leukocyte antigen in the immunotherapy of recurrent abortion with unknown cause. Methods from May 2013 to March 2015, Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology was selected for diagnosis of URSA. There were 243 patients who were negative for blocking antibody, according to the HLA-DR/DQ classification of the patients and the donors before treatment. The patients were divided into observation group (n = 130) and group A (n = 107). There were 2 compatible loci in group B (23 cases) and control group (113 cases). The positive rate of BA and the rate of successful pregnancy were compared after treatment. Results the positive rate of BA and the rate of successful pregnancy in group A were higher than those in control group and group B, respectively. The positive rate of BA and the rate of successful pregnancy in the control group were higher than those in group B. the donors with 0 or 1 HLA compatible site were selected in group A. The successful pregnancy rate in the observation group was significantly higher than that in the control group at the age of 35 years (P 0.05). A spouse or a third party was chosen to supply blood to the patient. After treatment, the successful pregnancy rate in the observation group was significantly higher than that in the control group (P 0.05). There was no significant difference in successful pregnancy rate (P0.05). Logistic regression analysis showed that age was the independent influencing factor of BA positive and successful pregnancy after active immunotherapy. HLA-DR/DQ typing can increase BA positive rate and successful pregnancy rate in URSA patients after immunotherapy.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院婦產(chǎn)科;
【分類(lèi)號(hào)】：R714.21
【正文快照】： 湖北武漢430000不明原因復(fù)發(fā)性流產(chǎn)(URSA)指在妊娠20周前連續(xù)發(fā)生3次或3次以上的自然流產(chǎn),是妊娠期最常見(jiàn)的并發(fā)癥之一,發(fā)病率1%~3%[1]。越來(lái)越多的研究表明,復(fù)發(fā)性流產(chǎn)(RSA)的發(fā)生與母胎免疫異常有關(guān)[2-4]。1976年,Rocklin首次提出母體血清中封閉抗體(BA)缺乏可導(dǎo)致流產(chǎn)。正

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