原因不明习惯性流产患者自身抗体的研究

The Study of Autoantibodies in Women with Habitual Abortion of Unknown Etiology

目的通过对原因不明习惯性流产（ＨＡ）患者进行多项自身抗体的筛查，研究ＨＡ与自身抗体的关系。方法６９例原因不明ＨＡ患者为研究组，其中原发性ＨＡ５１例（原发性ＨＡ组），继发性ＨＡ１８例（继发性ＨＡ组），３０例健康育龄妇女为对照组。对３组患者采用酶联免疫吸附法检测血清抗心磷脂抗体、抗单链及双链ＤＮＡ抗体，采用Ｈｅｐ－２细胞间接荧光法筛查抗核抗体，采用间接荧光法检测抗平滑肌、抗心肌及抗线粒体抗体，对７种可抽提的核抗原抗体采用免疫印迹扩散法检测。结果原发组中，自身抗体阳性３０例（５８．８％），其中抗心磷脂抗体阳性２３例（４５．１％），抗核抗体阳性１２例（２３．５％），抗平滑肌抗体阳性１３例（２５．５％）；继发组中，自身抗体阳性１１例（６１．１％），其中抗心磷脂抗体阳性８例（４４．４％），抗核抗体阳性４例（２２．２％），抗平滑肌抗体阳性５例（２７．８％）；研究组中有２１例多于一项自身抗体阳性（３０．４％）；对照组以上指标阳性数分别为５例（１６．７％）、３例（１０．０％）、２例（６．７％）。原发与继发ＨＡ组自身抗体阳性率均显著高于对照组（Ｐ＞０．０５），原发与继发ＨＡ组间差异无显著性（Ｐ＞０．０５）。结论多数原因不明性Ｈ?

Objective To evaluate the relationship between habitual abortion of unknown etiology and autoantibodies. Methods IgG and IgA antibodies against cardiolipin, specific antinuclear double stranded DNA and single stranded DNA were measured by enzyme linked immunosorbent assay (ELISA). Antinuclear antiboby, smooth muscle antiboby, antimitochondrial antiboby and antiheart muscle antiboby were performed by indirect immunofluorescence assay. Antiextractable nuclear antigen's antibodies were determined by immunodiffusion assay. Results Most women with habitual abortion of unknown etiology showed higher incidence of antibodies to cardiolipin, nuclear,smooth muscle compared with normal multigravida control( P <0.05). Conclusions These results indicate that most women with habitual abortion of unknown etiology have a higher level of autoreactivity, which may affect the course of pregnancy. The incidence of antismooth muscle antiboby in women with habitual abortion of unknown etiology is also increased compared with normal multigravida control.