妊娠合并抗磷脂综合征对妊娠结局的影响

Effect of pregnant outcome in women with antiphospholipid syndrome

目的 探讨抗磷脂综合征（APS）患者治疗前后的抗心磷脂抗体（ACA）的定性定量水平及其对妊娠结局的影响。方法用肝素配伍阿司匹林治疗APS40例，监测治疗前后ACA—IgG、IgM的变化。结果40例患者经治疗获活产婴儿37例，成功率为92．5％，妊娠丢失率（3例，7．5％）；定量方法检测治疗前的ACA-IgG和ACA-IgM分别为（67．63±2．53）u和（49．40±3．64）u；治疗后的ACA—IgG和ACA—IgM滴度分别为（23．87±1．54）u和（21．60±2．59）u，两者比较，治疗后的ACA滴度水平显著低于治疗前水平（P〈0．01）；40例患者治疗后ACA定性水平呈总体下降趋势，治疗后（孕中期）ACA-IgG阳性率（40．0％），低于治疗前（52．5％）（X^2=3．85，P〈0．05）；治疗后（产后1月）ACA—IgM阳性率（37．5％），低于治疗前（47．5％）（X^2=3．81，P〈0．05）。结论肝素联合阿司匹林治疗抗磷脂综合征安全有效。

Objective To investigate the efficacy to pregnant outcome with anticardiolipin antibody（ACA） of qualitative and quantitative before treatment and after treatment in women pregnant with antiphospho-lipid syndrome （APS）. Methods The heparin combined with aspirin therapy APS 40 patients before and after treatment to monitor the change of ACAIgG, IgM. Results 40 patients were treated 37 cases of live births, success rate were 92. 5%, the rate of pregnancy loss were3 cases （ 7.5% ） ; The lever of ACA-IgG and ACA-IgM were （ 67.63 ±2. 53 ） U and （49. 40 ± 3. 64） U before treatment and lever of ACA-IgG and ACA-IgM were （23. 87 ± 1.54） U and （21.60 ± 2. 59） U after treatment, The lever after treatment were significantly lower than the before treatment （P 〈 0. 01 ） ; The level of ACA were overall downward in 40 cases after treatment by dynamic observation; The rate of positive in ACAIgG （40. 0） % after treatment lower than before treatment（52. 5 ） % （ X^2 = 3.85, P 〈 0. 05 ） ; The rate of positive in ACA IgM （37.5） % after treatment lower than before treatment （ 47. 5 ） % （ X^2 = 3.81, P 〈 0. 05 ）. Conclusion Heprinar treatment combined with aspirinmay be a safe and effeetive method for patients with APS.