人类白细胞抗原分型在淋巴细胞主动免疫治疗不明原因复发性流产中的价值研究

发布时间：2018-01-16 22:09

本文关键词：人类白细胞抗原分型在淋巴细胞主动免疫治疗不明原因复发性流产中的价值研究　出处：《中国实用妇科与产科杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨人类白细胞抗原(HLA)-DR/DQ分型在免疫治疗不明原因复发性流产(URSA)中的价值。方法选择2013年5月至2015年3月在华中科技大学同济医学院附属同济医院确诊为URSA、封闭抗体(BA)为阴性的患者243例,根据患者治疗前是否检测自身及供血者的HLA-DR/DQ分型,分为观察组130例(HLA相容位点≤1个为A组107例,相容位点有2个为B组23例)和对照组113例(治疗前未检测患者及供血者的HLA-DR/DQ分型)。比较各组治疗后的BA阳性率及成功妊娠率,用多因素非条件Logistic回归进行相关因素分析。结果 A组BA阳性率及成功妊娠率分别高于对照组及B组,对照组BA阳性率及成功妊娠率高于B组(均P0.05)。在A组中选择与患者有0或1个HLA相容位点的供血者,患者治疗后,成功妊娠率差异无统计学意义(P0.05)。患者年龄35岁时,观察组成功妊娠率明显高于对照组(P0.05)。选择配偶或第三方供血,患者治疗后,成功妊娠率差异无统计学意义(P0.05)。Logistic回归分析显示年龄是主动免疫治疗后BA阳性及成功妊娠的独立影响因素。结论 HLA-DR/DQ分型可提高URSA患者免疫治疗后BA阳性率及成功妊娠率。
[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.
【作者单位】：华中科技大学同济医学院附属同济医院妇产科;
【分类号】：R714.21
【正文快照】： 湖北武汉430000不明原因复发性流产(URSA)指在妊娠20周前连续发生3次或3次以上的自然流产,是妊娠期最常见的并发症之一,发病率1%~3%[1]。越来越多的研究表明,复发性流产(RSA)的发生与母胎免疫异常有关[2-4]。1976年,Rocklin首次提出母体血清中封闭抗体(BA)缺乏可导致流产。正

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