摘要
目的探讨联合多次检测抗心磷脂抗体(ACA)和抗β2-糖蛋白抗体(抗β2-GPI抗体)对自身免疫型复发性流产的临床诊断价值。方法2005年1月至2007年4月在上海交通大学医学院附属仁济医院妇产科就诊的417例有复发性流产史的患者作为研究病例。应用酶联免疫吸附(ELISA)法,对患者血清中的ACA及抗β2-GPI抗体进行检测。每隔3周1次,连续14次。结果患者抗磷脂抗体(APA)总阳性率达21.8%,其中ACA阳性率为18.7%、抗β2-GPI抗体阳性率为7.7%、ACA和抗β2-GPI抗体双阳性率为4.6%。自身抗体阳性检出率随检测次数的增加而逐渐增加:在确诊的91例APA阳性患者中,测定4次阳性率仅为68.13%;测定5次以上阳性率≥81.32%,与测定4次者比较差异有统计学意义(P<0.05)。结论ACA和抗β2-GPI抗体联合、多次测定,可以提高自身免疫型复发性流产患者APA检测率,减少漏诊率。为了提高自身免疫型复发性流产的诊断率,建议临床上对APA的测定次数,应根据病情需要进行5次以上测定。
Objective Serum ACA and anti-β2-GPI antibody title were detected consecutively as single and combined test to evaluate their value in the screening autoimmune type of recurrent spontaneous abortion （RSA）. Methods 417 women with RSA were enrolled in Renji hospital between January 2005 and April 2007. Sera were collected from these 417 patients and analyzed for ACA and anti-β2-GPI antibody by enzyme linked immunosorbent assay （ELISA）. The antibodies were detected once 3 weeks for 14 times. Results The co-measurement of ACA and anti-β2-GPI antibody could increase the positive rate up to 21.8% in comparison with single positive of ACA （ 18.7% ）, single positive of anti-β2- GPI antibody （7.7%）, and double positive rate of ACA and anti-β2-GPI antibody （4.6%）. 91 patients were definitely diagnosed with positive antiphospholipid antibodies （APA）, with more times of screening of ACA and anti-β2-GPI antibody, more patients with APA were found. The positive rates of 5 times and more than 5 times screening were more than 81.32% , which was statistically significant in comparison with that of 4 times screening （68.13%） （ P 〈 0.05 ）. Conclusion The consecutive co-measurement of ACA and anti-β2-GPI antibody might increase positive rate in screening of autoimmune type of RSA. It suggested that the times of screening of ACA and anti-β2-GPI antibody in patients with RSA should be performed 5 times or more, which will be appropriate.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2007年第10期760-762,共3页
Chinese Journal of Practical Gynecology and Obstetrics
