配偶淋巴细胞体外诱生免疫及地屈孕酮治疗不明原因反复自然流产的疗效比较及对围产期母婴的影响

发布时间：2018-06-29 20:41

本文选题：不明原因反复自然流产(URSA) + 地屈孕酮　；参考：《生殖与避孕》2015年12期

【摘要】：目的:探讨配偶淋巴细胞体外诱生免疫联合地屈孕酮治疗对不明原因反复自然流产(URSA)患者再次妊娠结局及对孕妇围产期并发症的发生和新生儿发育的影响。方法:随访分析254例URSA患者,其中A组84例接受配偶淋巴细胞体外诱生免疫治疗;B组86例接受地屈孕酮治疗;C组84例接受体外诱生免疫联合地屈孕酮治疗;比较3组患者接受治疗后的再次妊娠成功率,以及围产期孕产妇的情况和新生儿的发育。结果:3组患者再次妊娠成功率分别为89.3%、70.9%和92.8%。B组低于其他各组,且差异有统计学意义(P0.05)。3组患者新生儿的分娩孕周无统计学差异(P0.05);足月新生儿出生体质量及身长组间无统计学差异(P0.05);各组与正常参照标准比较差异无统计学意义(P0.05)。3组间围产期妊娠并发症及新生儿畸形的发生率与流行病学调查数据比较无统计学差异(P0.05)。结论:与单用地屈孕酮治疗比较,配偶淋巴细胞体外诱生免疫,或诱生免疫联合地屈孕酮治疗显著增加URSA患者再次妊娠的成功率;3种方法治疗均不影响新生儿生长发育;与正常妊娠相比,3种治疗均不增加孕妇围产期妊娠并发症与新生儿畸形率。
[Abstract]:Objective: to investigate the effects of conjugate lymphocyte induced immunotherapy combined with diproprogesterone on the repregnancy outcome of recurrent spontaneous abortion (Ursa) patients with unknown causes and the occurrence of perinatal complications and neonatal development in pregnant women. Methods: 254 patients with Ursa were followed up. Among them, 84 cases in group A received conjugal lymphocyte induced immunotherapy in vitro, 86 cases in group B received diproprogesterone therapy, 84 cases in group C received in vitro immunization combined with diproprogesterone. The success rate of re-pregnancy, perinatal pregnancy and neonatal development were compared among the 3 groups. Results the success rate of repregnancy was 70.9% in group B and 70.9% in group B, respectively, and was lower in group B than in other groups. The difference was statistically significant (P0.05), there was no significant difference in gestational weeks (P0.05), there was no significant difference in birth weight and body length of full-term neonates (P0.05), and there was no significant difference between each group and normal reference standard (P0.05). There was no significant difference in the incidence of perinatal complications and neonatal malformations between the two groups compared with the epidemiological survey data (P0.05). Conclusion: compared with the treatment of single use of progesterone, the in vitro immunization of spouse lymphocytes or the combination of induced immunization with diproprogesterone can significantly increase the success rate of recurrent pregnancy in patients with Ursa. All of the three treatments have no effect on the growth and development of newborns. Compared with normal pregnancy, all three treatments did not increase the rate of perinatal complications and neonatal malformation.
【作者单位】：复旦大学附属妇产科医院研究所;
【基金】：上海卫生系统先进适宜技术推广项目(2013SY034) 国家自然科学基金面上项目(31171437)
【分类号】：R714.21

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