调免3号对封闭抗体缺乏型反复自然流产免疫调节作用

作者	单位
高汉义	潍坊医学院中医教研室
陶恩学	潍坊医学院附属医院中医科
王燕	潍坊医学院中医教研室
岳启安	潍坊医学院不孕不育研究所
任春娥	潍坊医学院免疫学教研室
闫乐法	潍坊医学院生殖医学中心

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中文摘要:

目的探讨中药调免3号对母血封闭抗体缺乏型反复自然流产(recurrent spontaneous abortion,RSA)免疫调节作用。方法将封闭抗体缺乏型RSA患者61例,采用抽签法随机分成2组,试验组31例服用中药调免3号治疗;对照组30例采用配偶淋巴细胞主动免疫治疗。治疗时间均为3个月,另选10名健康同龄女性为健康对照组。治疗前后检测封闭抗体效率(blocking antibodies,Ab1)、抗独特型抗体(anti-idiotypicantibodies,Ab2)、T细胞亚群(T-lymphocyte cell subsets,CD4,CD8)、IL-10、巨噬细胞集落刺激因子(macrophagecolony-stimulating factor,M-CSF)的水平。结果 (1)试验组治疗后Ab1和(或)Ab2阳转率达87.1%(27/31),对照组为86.7%(26/30),两组比较差异无统计学意义(P>0.05)。(2)两组治疗后皆CD4下降,CD8提高,CD4/CD8比值处于人体正常值水平,与治疗前比较差异有统计学意义(P<0.05)。(3)两组治疗后IL-10、M-CSF升高,与治疗前比较差异有统计学意义(P<0.05)。(4)试验组1年受孕率58.1%(18/31),高于对照组的46.7%(14/30,P<0.05)。结论中药调免3号可促进母体封闭抗体阳转率,促进IL-10、M-CSF细胞因子的产生,从而加强了母体对胎儿的保护作用和对妊娠的正常维持,1年成功妊娠率明显升高。

英文摘要:

Objective To study the immunoregulation effects of Tiaomian No.3(TM3) for recurrent spontaneous abortion(RSA) caused by shortage of blocking antibodies.Methods Totally 61 patients with RSA caused by shortage of blocking antibodies were randomly assigned to the treatment group(31 cases) and the control group(30 cases) by lot method.Patients in the treatment group were treated with TM3,while those in the control group were treated with active immunotherapy using lymphocytes of their spouses.The therapeutic course for all was 3 months.Another 10 healthy females in the same age ranges were recruited as the healthy control group.The blocking antibodies(Ab1),anti-idiotypic antibodies(Ab2),T-lymphocyte cell subsets(CD4 and CD8),serum interleukin 10(IL-10),and macrophage colony-stimulating factor(M-CSF) levels were determined before and after treatment.Results (1) After treatment the positive conversion rate of Ab1 and/or Ab2 was 87.1%(27 /31) in the treatment group and 86.7%(26 /30) in the control group,showing no statistical difference(P >0.05).(2) In the two groups,CD4 decreased and CD8 increased.The CD4 /CD8 ratio was in the normal level after treatment,showing statistical difference when compared with before treatment(P <0.05).(3) In the two groups,IL-10 and M-CSF levels were higher after treatment,showing statistical difference when compared with before treatment(P <0.05).(4) The 1-year conception rate was 58.1%(18 /31) in the treatment group,significantly higher than that in the control group(46.7%,14 /30,P < 0.05).Conclusions TM3 could promote the positive conversion rate of Ab1,promote the production of IL-10 and M-CSF cytokines,thus strengthening the protection for fetus by the mother and the normal maintenance for pregnancy.The 1-year successful pregnancy rate obviously increased in the treatment group.

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