复发性流产患者自身免疫性抗体的变化研究

Study on Relationship Between Autoantibodies Spectrum and Recurrent Spontaneous Abortion

目的:探讨自身免疫性抗体ACA、β2GP1-IgG/IgM、APE、aPS、TPOAb和TgAb与复发性流产(RSA)的关系。方法:选取100例有复发性流产史未孕妇女为研究组,其中原发性RSA62例,继发性RSA38例,另选100例有正常妊娠史、未孕健康妇女为对照组,测定两组血清中ACA、β2GP1-IgG/IgM、APE、aPS、TPOAb和TgAb。比较2组中抗体的阳性率。结果:研究组与对照组中ACA、β2GP1-IgG/IgM、APE、aPS/IgG、aPS/IgM、TPOAb和TgAb的抗体阳性率分别为8%、11%、41%、0%、0%、28%、24%和0%、0%、9%、0%、0%、6%、4%。aPS(IgG和IgM)在两组中比较差异无显著性,其余各项两组比较差异有显著性(P<0.05)。抗甲状腺抗体阳性者ACA、β2GP1-IgG/IgM及APE的阳性率分别为2.6%、7.9%和26.3%;抗甲状腺抗体阴性者ACA、β2GP1-IgG/IgM及APE的阳性率分别为4.3%、4.9%和24.7%,两组比较差异无显著性(P>0.05)。结论:自身免疫性抗体与复发性流产有关,抗甲状腺抗体是复发性流产的独立危险因素。

Objective： To study the relationship between autoantibodies and recurrent spontaneous abortion （RSA）.Methods：100 non-pregnant women with a history of recurrent spontaneous abortion served as study subjects, that being further divided into2 subgroups corresponding to62 （primary RSA） and38 （secorclary RSA）. 100 healthy non-pregnant women with a normal pregnant history served as controls. Serum ACA, β2GP1-IgG/IgM, APE, aPS, TPOAb, and TgAb were determined by ELISA and compared among them. Results： The positive rates of serum autoantibodies ACA-IgG/IgM, β2GP1-IgG/IgM, APE-IgG/IgM, aPS（IgG）, aPS（IgM）, TPOAb and TgAb in study subjects were 8%, 11%, 41%,0%, 0%, 28%, and 24%, respectively, the corresponding positive rate in control group was 0%, 0%, 9%, 0%, 0%, 6%, and 4%, respectively. There were significant difference of these autobodies between two groups except aPS（IgG） and aPS （IgM）（P〈0.05）. The positive rates of ACA, β2GP1- IgG/IgM, and APE in patients with positive or negative antithyroid antibodies was 2.6%/4.3%, 7.9%/4.9%, and 26.3%/24.7%, respectively, no significant difference was found between them （P〉0.05） .Conclusions：Antithyroid antibodies may be markers of autoimmune activation and have not associated with antiphospholipid antibodies.