摘要
目的:探讨原因不明复发性自然流产(URSA)患者的心理健康状况及心理干预对其免疫功能和治疗效果的影响。方法:采用症状自评量表(SCL-90)对142例URSA患者和102例正常妇女进行心理状况调查,URSA患者知情选择分为淋巴细胞主动免疫组、心理干预联合黄体酮组和单纯黄体酮组,并用双抗体夹心酶联免疫吸附法检测治疗前、后Th1(IFN-γ、TNF-α)和Th2(IL-4、IL-10)细胞因子水平,并观察妊娠结局。结果:URSA患者SCL-90自评总分、总均分、抑郁、人际关系敏感因子均高于正常对照组(P<0.05);治疗前URSA患者IFN-γ、TNF-α水平高于正常对照组(P<0.05),IL-4水平低于正常对照组(P<0.05)。主动免疫治疗后IFN-γ、TNF-α水平降低(P<0.05),IL-4和IL-10水平升高(P<0.05);心理干预联合黄体酮治疗后IFN-γ、TNF-α水平降低(P<0.05)。随访至足月分娩,主动免疫组、心理干预联合黄体酮组和黄体酮组妊娠成功率分别为85.71%(54/63)、83.67%(41/49)和73.33%(22/30),黄体酮组的妊娠成功率低于其他两组(P<0.05)。结论:反复自然流产可以影响妇女的正常心理活动,较差的心理状态干扰机体免疫功能,适当心理干预可调整机体免疫功能,提高治疗效果,有临床应用价值。
Objective：To investigate the psychological factors of recurrent abortion and the influence of psychological intervention on immune function and treatment in patients undergoing recurrent abortion.Methods：A total of 142 unexplained recurrent spontaneous abortion（URSA） cases and 102 normal cases were assessed psychological factors with Self-reporting Inventory（SCL-90） and URSA patients were divided into three groups including group A（treated with active immunotherapy）,group B（treated with psychological intervention adding progesterone therapy） and group C（treated with progesterone therapy） for prospective study.Serum IFN-γ,TNF-α,IL-4 and IL-10 levels were detected and the outcome of pregnancy was recorded after three kinds of therapy.Results：The total scores,total average scores,depress scores and sensitive interpersonal relationship scores in SCL-90 of URSA patients were significantly higher than those of normal women（P0.05）.The levels of IFN-γand TNF-α of URSA patients were significantly higher and the IL-4 level was significantly lower than those of nomal women before therapy.The levels of IFN-γ and TNF-α were significantly lower than those before active immunotherapy and psychological intervention adding progesterone therapy（P0.05）,the levels of IL-4 and IL-10 were significantly higher than those before active immunotherapy（P0.05）.The success rates of pregnancy in group A,group B and group C were 85.71%（54/63）,83.67%（41/49） and 73.33%（22/30）,respectively.The success rate of pregnancy in group C was significantly lower than that in other groups（P0.05）.Conclusion：Recurrent abortion can affect the normal psychological factors and abnormal psychological status can disturb immune function.Psychological intervention is probably useful in alleviating anxiety level and improving immune function of women undergoing recurrent abortion.
出处
《生殖与避孕》
CAS
CSCD
2013年第7期463-468,共6页
Reproduction and Contraception
基金
新疆维吾尔自治区自然科学基金青年基金项目
项目编号:2013211B57
关键词
复发性流产
心理健康状况
心理干预
细胞免疫
主动免疫治疗
recurrent abortion
psychological factor
psychological intervention
cellular immunity
active immunotherapy
