反复自然流产患者甘露聚糖结合凝集素和生殖相关抗体的检测及意义

The detection and significance of mannan-binding lectin and antibodies associated with generate in patients with recurrent spontaneous abortion

目的了解不明原因反复自然流产(RSA)和正常妊娠妇女血清中甘露聚糖结合凝集素(MBL)浓度及与5种生殖相关抗体的关系。方法用ELISA法测定RSA患者及正常早、中、晚妊娠期妇女血清中MBL的含量,同时检测RSA患者血清中抗弓形虫抗体(ATAb)、抗人巨细胞病毒抗体(HCMV-IgM)、抗精子抗体(ASAb)、抗子宫内膜抗体(EMAb)和抗心磷脂抗体(ACL)。结果RSA组(n=51)、对照组(n=55)、正常早孕(n=32)、中孕(n=34)和晚孕(n=28)妇女组的血清MBL浓度分别为1.40±0.63 mg/L,2.03±0.89 mg/L,2.47±0.85 mg/L,2.73±1.07 mg/L和3.22±1.08 mg/L。RSA组血清MBL浓度显著低于对照组(t=4.15,P<0.01)。正常妊娠妇女血清MBL浓度随妊娠时间逐渐增高,浓度显著高于对照组(P<0.05-0.01)。RSA组血清中4种生殖相关抗体(ATAb、ASA、EMAb和ACL)阳性率显著高于对照组(P<0.01-0.05)。RSA组MBL浓度<1.0 mg/L者27.5%(14/51),抗体总阳性率为85.7%(12/14)显著高于MBL浓度≥1.0 mg/L患者的抗体阳性率32.4%(12/37)(P<0.01)。结论部分RSA患者血清MBL浓度降低与免疫调理功能缺陷和感染率增加有关,这可促使发生RSA。

Objective To investigate the significance of marman-binding lectin（MBL）concentmtion and five antibodies of corre-lated generation in patients with recurrent spontaneous abortion（RSA）and nomaal pregnancy woman.Methods The MBL concentration and five antibodies including antitoxo plasma（ATAb ） antihuman cytomegalo viru（HCMV-IgM）, antisperm（ASAb ）, antiendometrium（EMAb） and anticardiolipin（ACL）were detected by sandwich enzyme linked inmaunosorbent assay （EIJSA） in RSA patients and woman with different duration of pregnancy. Results The serum concentration of MBL in RSA group（ n = 51 ）, control group（ n = 55 ）, early pregnancy group（ n = 32）, middle pregnancy group（ n = 34）and late pregnancy group（ n = 28 ）were 1.40 ± 0.63 mg/L, 2.03 ± 0.89 mg/L, 2.47 ± 0.85 mg/L, 2.73 ± 1.07 mg/L and 3.22 ±1.08 mg/L, respectively. MBL concentration in RSA group were significantly lower than those in control subjects（ t = 4.15, P 〈 0.01 ）. MBL concentration in normal pregnancy, woman were found to increase gradually with gestation and were significantly higher than those in control subjects（ P 〈 0.01）. The positive rates of four antibodies（ATAb,ASAb,EMAb and ACL）of correlated generation in RSA group were significantly higher than those in control group（ P 〈 0.01 - 0.05）. The five antibodies percentages in RSA group were significantly different bewteen MBL concentration of RSA patients（ 85.7 %, 12/14） with MBL concentration lower than 〈 1.0 mg/L and those（32.4%, 12/37） with MBL concentration higher than≥1.0 mg/L（ P 〈 0.01）. Conclusion The lower MBL concentration in serum of some RSA patients are related to immunologic regulation deficiency and increase of infection rates.This may be facilitate the development of RSA.