妊娠丢失与抗磷脂抗体的关系

Relationship between Pregnancy Loss and Antiphospholipid Antibody

目的探讨妊娠丢失与抗磷脂抗体［ＡＰＡ，包括抗心磷脂抗体（ＡＣＡ）和狼疮抗凝抗体（ＬＡ）］的关系。方法对１２２例有不明原因妊娠丢失史的患者（研究组）和１００例正常非孕妇女（对照组），分别采用酶联免疫吸附法和活性部分凝血酶原时间法，测定静脉血清中的ＡＰＡ。其中，研究组分为胚胎停育组（２８例）、死胎组（３１例）和复发性流产组（６３例）。结果整个研究组中ＡＰＡ、ＡＣＡ、ＬＡ的阳性百分比均高于对照组，与对照组相比，差异均有显著性（Ｐ＜０．０５～０．００１）。死胎组和复发性流产组此３项指标的阳性百分比分别与对照组比较，差异有显著性（Ｐ＜０．０５～０．００１），而胚胎停育组与对照组相比，差异无显著性（Ｐ＞０．０５）。结论ＡＰＡ与妊娠丢失有关，尤其是复发性流产和死胎。因此，应对有不良孕产史的患者常规筛查ＡＰＡ，以利于尽早对因治疗。

Objective To investigate the relationship between history of pregnancy loss and antiphospholipid antibodies (APA), including anticardiolipin (ACA) and lupus anti coagulant antibodies (LA). Methods Levels of serum APA, ACA and LA were determined by enzyme linked immunoabsorbent assay and activated partial thromboplastin time method respectively in 122 patients with history of unexplained pregnancy loss (study group) and 100 normal nonpregnant women (control group). The study group was further divided into three subgroups: embryo growth arrest ( n =28), stillbirth ( n =31), and recurrent abortion ( n =63). Results The positive rates of APA, ACA, LA in the study group were significantly higher than those in controls ( P <0.05￣0.001). The above significance was true in both stillbirth and recurrent abortion groups but not in embryo growth arrest group.Conclusions Levels of serum APA were associated with pregnancy loss, especially recurrent abortion and stillbirth. We suggested routine screening of serum APA should be performed in patients with history of fetal wastage for the sake of early treatment.