Effects Of Prednisone On Nk Cells And T Lymphocyte Subsets In Patients With URSA And The Efficacy Of Combined IVIG In The Treatment Of URSA

Objective To investigate the effect of prednisone on NK cells and T lymphocyte subsets(CD4,CD8,CD4/CD8)in patients with unexplained recurrent spontaneous abortion.Methods With reference to the consensus of experts in diagnosis and treatment of recurrent abortion in China in 2016,the diagnostic criteria of recurrent abortion,Select the First Affiliated Hospital of Anhui Medical University 2016.11-2017.12 diagnosed as unexplained recurrent miscarriage 47 cases,NK cells accounted for more than 16.4% of peripheral blood mononuclear cells,.Given a small dose of prednisone(5mg/Bid),drawn at the time of treatment and after 4 weeks of prednisone treatment of fasting peripheral venous blood 2ml by flow cytometry to detect the level of NK cells and T lymphocytes(CD4,CD8,CD4/CD8)Subpopulation level.The level of NK cells and the ratio of T lymphocyte(CD4,CD8,CD4/CD8)subsets were compared before and after treatment.Results Pre-treatment with prednisone,peripheral blood NK cell levels were(25.16±8.41%),after treatment(19.90±7.12%),The level of NK cells in peripheral blood decreased after prednisone treatment,with significant difference;Pre-treatment with prednisone CD4+ T cells in peripheral blood(34.46±6.36%),after treatment(37.24±6.36%),before prednisone treatment CD4+T/CD8+T ratio in peripheral blood(1.44±0.61),after treatment(1.56±0.63),the proportion of CD4 + T lymphocytes and the ratio of CD4+T/CD8+T in peripheral blood increased after treatment,and the difference was statistically significant;Pre-treatment with prednisone CD8+ T cell in peripheral blood were(26.28±7.19%),after treatment(26.38±6.96%),The proportion of CD8+T lymphocytes before and after no significant change,the difference was not statistically significant.Conclusion Prednisone can reduce the level of NK cells in peripheral blood of patients with recurrent spontaneous abortion and regulate the proportion of T lymphocyte subsets。Objective To study the therapeutic effect of low-dose prednisone combined with immunoglobulin during pregnancy on RSA patients with elevated peripheral NK cell levels before pregnancy.Methods Fifty-three RSA patients with elevated levels of peripheral blood NK cells before recurrent miscarriage were diagnosed in the First Affiliated Hospital of Anhui Medical University from 2016.11 to 2017.12,given low doses of prednisone(5mg/Bid),after contraception 2-3 months the guidance of pregnancy,according to whether intravenous immunoglobulin after pregnancy treatment is divided into test group and control group.Both groups were given low-dose aspirin(25mg /d)and folic acid(400mg/d)at the time of conception,and received conventional treatment of dydrogesterone(10mg,BID)during pregnancy.Results In the test group,29 cases of URSA had successful pregnancy in 25 cases and pregnancy failure in 4 cases with a success rate of 86.21%.In 24 cases of URSA in control group,15 cases succeeded in pregnancy and 9 cases failed in pregnancy with a success rate of 62.50% The χ2 test showed that the two groups were statistically significant.Pre-treatment with prednisone,pregnancy success of pre-treatment with prednisone NK cell levels(24.14 ± 6.82%),pregnancy failure of pre-treatment with prednisone NK cell level(24.52 ± 6.60%),pregnancy success and pregnancy failure the difference of NK cell levels was not statistically significant.Conclusion Pre-pregnancy low-dose prednisone combined with immunoglobulin after pregnancy benefit elevated peripheral blood NK cells in patients with RSA treatment.This therapy is better then low-dose prednisone.