主动免疫治疗对体外受精-胚胎移植的反复性自然流产患者的临床应用价值
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江苏省医学重点学科(XK200702);江苏省卫生厅项目(H200905)


Clinical value of active immunotherapy in the treatment of IVF-ET RSA
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    目的:探讨主动免疫治疗对体外受精-胚胎移植的反复性自然流产(recurrent spontaneous abortion,RSA)患者的临床应用价值-方法:分析2003年7月~2011年4月,在南京医科大学第一附属医院临床生殖科免疫治疗的42例RSA患者行IVF/ICSI治疗的62个周期-RSA患者采用淋巴细胞行主动免疫治疗,妊娠后分别采用人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)或黄体酮保胎治疗-结果:移植胚胎数目为116个,平均移植胚胎数目为(1.87 ± 0.61)个,HCG日内膜厚度为(9.08 ± 2.03)mm-成功率为64.29%(27/42),免疫妊娠成功率96.43%(27/28),胚胎种植率28.45%(33/116),生化妊娠率50.00%(31/62),临床妊娠率45.16%(28/62),流产率3.57%(1/28),活产率24.19%(15/62),剖宫产率93.33%(14/15)-结论:对于行IVF/ICSI治疗的RSA患者,主动免疫治疗可以提高患者免疫反应性,有效降低流产率,有助于妊娠成功,是一种安全简单有效的治疗方法-

    Abstract:

    Objective: To investigate the clinical value of active immunotherapy in the treatment of IVF-ET RSA. Methods: We retrospectively analyzed 62 cycles of IVF/ICSI RSA among 42 infertile couples during July 2003 to April 2011.The RSA patients were treated by active immunotherapy combined with tocolysis using HCG or Progesterone after pregnancy. Results: The number of embryo transferred was 116,the average number of embryo transferred was 1.87 ± 0.61,and the endometrial thickness of HCG day was (9.08 ± 2.03) mm. The achievement rate was 64.29%(27/42),the pregnancy achievement rate behind immunotherapy treatment was 96.43%(27/28),the embryo implantation rate was 28.45%(33/116),the biochemical pregnancy rate was 50.00%(31/62),the clinical pregnancy rate was 45.16%(28/62),the miscarriage rate was 3.57%(1/28),the live birth rate was 24.19%(15/62),the cesarean section rate was 93.33%(14/15). Conclusion: In IVF/ICSI RSA,the active immunotherapy can improve the patient immunity reactivity,effectively reduce the miscarriage rate,and improve the successful pregnancy. So it is a safe and simple treatment.

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张 燕,陶淑贞,丁 卫,钱晓乔,王 媁,冒韵东,刘嘉茵.主动免疫治疗对体外受精-胚胎移植的反复性自然流产患者的临床应用价值[J].南京医科大学学报(自然科学版),2011,(12):1807-1810

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  • 收稿日期:2011-09-17
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