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目的分析醋酸泼尼松治疗原因不明复发性自然流产(URSA)的临床结局(持续妊娠>12周)及治疗前、后NK细胞CD56、CD16变化。方法选择URSA患者160例,分为2组,每组80例。试验组给予醋酸泼尼松及阿司匹林治疗;对照组给予安慰剂及阿司匹林治疗;治疗周期始于孕4~5周止于孕12周,如治疗期间流产即停药。采用流式细胞仪测定治疗前、后外周血NK细胞CD56、CD16百分率。结果试验组持续妊娠>12周百分率高于对照组(P=0.00);试验组治疗后CD16较治疗前降低(P=0.00);对照组治疗前、后CD16差异无统计学意义(P=0.79);试验组、对照组治疗前、后CD56差异无统计学意义(试验组P=0.09,对照组P=0.12)。结论醋酸泼尼松改善URSA患者的临床结局可能与CD16降低、抑制细胞毒性作用有关。
Objective To analyze the clinical outcomes (continuous pregnancy> 12 weeks) of prednisone acetate in the treatment of unexplained recurrent spontaneous abortion (URSA) and the changes of CD56 and CD16 in NK cells before and after treatment. Methods A total of 160 URSA patients were selected and divided into two groups, 80 cases in each group. The experimental group was treated with prednisone acetate and aspirin. The control group was given placebo and aspirin. The treatment cycle started at 4 to 5 weeks of gestation and was stopped at 12 weeks of gestation. If the abortion was discontinued during the treatment period, the drug was discontinued. Flow cytometry was used to determine the percentage of CD56 and CD16 in peripheral blood NK cells before and after treatment. Results The percentage of continuous pregnancy> 12 weeks in trial group was higher than that in control group (P = 0.00). CD16 in trial group was lower than that before treatment (P = 0.00); CD16 in control group was no significant difference (P = 0.79 ). There was no significant difference in CD56 between the experimental group and the control group before and after treatment (P = 0.09 in the experimental group and P = 0.12 in the control group). Conclusion The clinical outcome of prednisone acetate in improving URSA patients may be related to the decrease of CD16 and cytotoxicity.