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目的探讨不明原因复发性自然流产(URSA)患者免疫治疗前后免疫细胞特征及其临床意义,为该疾病防治提供临床依据。方法回顾性分析62例早期复发性流产患者免疫细胞表达情况,使用流式细胞术,检测其外周血T细胞亚群,包括T细胞数量、Th细胞数量、Ts细胞数量及Th/Ts,以及WBC数量、LYM数量、B细胞比例、T细胞比例、NK细胞比例,了解RSA患者免疫状态。同期,选取44例偶发自然流产患者作为对照。对两组患者进行主动免疫治疗,记录妊娠后两组患者的免疫细胞变化情况及妊娠结局。结果 (1)妊娠前URSA组Th/Ts、WBC数量及NK细胞比例高于偶发流产组(P<0.05),妊娠后URSA组WBC高于偶发流产组(P<0.05);(2)经主动免疫治疗后URSA组成功率为94.0%,妊娠前后比较,T细胞、Th细胞、Ts细胞、WBC、B细胞上升,LYM、NK细胞、Th/Ts下降(P<0.05),下降幅度以URSA组明显。结论 Th/Ts联合NK细胞比例可作为评价URSA患者免疫状态、检测妊娠前后机体免疫功能的的重要指标,主动免疫治疗可降低URSA患者Th/Ts、NK细胞比例,提高妊娠成功率。
Objective To investigate the characteristics of immune cells in patients with unexplained recurrent spontaneous abortion (URSA) before and after immunotherapy and their clinical significance, and to provide a clinical basis for the prevention and treatment of this disease. Methods The expression of immune cells in 62 patients with early recurrent spontaneous abortion were retrospectively analyzed. The T lymphocyte subsets in peripheral blood including number of T cells, number of Th cells, number of Ts cells and Th / Ts, and WBC Quantity, number of LYM, proportion of B cells, proportion of T cells, proportion of NK cells, to understand the immune status of RSA patients. The same period, select 44 cases of spontaneous abortion as a control. The two groups of patients were active immunotherapy, recording changes in immune cells and pregnancy outcomes in both groups after pregnancy. Results (1) The numbers of Th / Ts and WBC and the proportion of NK cells in URSA group before pregnancy were higher than those in sporadic abortion group (P <0.05), and those in URSA group were higher than those in sporadic abortion group after pregnancy (P <0.05). (2) The success rate of URSA after immunotherapy was 94.0%. Before and after pregnancy, T cells, Th cells, Ts cells, WBC, B cells increased, LYM, NK cells and Th / Ts decreased (P < . Conclusion The ratio of Th / Ts combined with NK cells can be used as an important index to evaluate the immune status of URSA patients before and after pregnancy. Active immunotherapy can reduce the proportion of Th / Ts and NK cells in URSA patients and improve the success rate of pregnancy.