抗β2糖蛋白Ⅰ抗体对抗磷脂综合征患者妊娠丢失及免疫调节治疗疗效影响

The influences of anti-β2-glycoprotein Ⅰ antibodies on pregnancy loss and therapeutic reaction of patients with APS

目的探讨抗β2糖蛋白Ⅰ(β2GPⅠ)抗体对抗磷脂综合征患者妊娠丢失及免疫调节治疗疗效的影响。方法将2006年6月至2009年12月在中南大学湘雅二医院产科住院治疗的抗磷脂综合征确诊患者共191例按不同抗体阳性分为3组:A组154例:抗心磷脂抗体(ACA)(+),β2GPⅠ(-);B组26例:ACA(+),β2GPⅠ(+);C组11例:ACA(-),β2GPⅠ(+)。分析各组的妊娠丢失率及免疫治疗的疗效。结果治疗前,A、B、C3组间妊娠丢失率(61.59%,69.84%,67.86%)差异无统计学意义(P>0.05)。经免疫调节治疗后,B组(46.15%)患者妊娠丢失率明显高于A组(22.08%),差异有统计学意义(P<0.05);C组(36.36%)与A组、B组比较差异无统计学意义(P>0.05)。结论抗β2GPⅠ抗体对抗磷脂综合征患者妊娠丢失率的影响与ACA相似;抗β2GPⅠ抗体(+)合并ACA(+)的抗磷脂综合征患者对免疫调节治疗的疗效欠佳。

Objective To study the influences of anti-β2-glyeoprotein I antibodies on pregnancy loss and therapy response of patients with APS. Methods 191 patients with APS were divided into 3 groups according to different antibodies detec- ted, group A： ACA（ ＋ ）β2GP I （ - ） （n = 154） ; group B： ACA（ ＋ ） I32GP I （ ＋ ） （n =26） ; group C： ACA（ - ） [32GP I （ ＋ ） （ n = 11 ）. Analyze the pregnancy rate and therapeutic reaction of the patients. Results The pregnancy loss rate of group A, B and C before therapy were respectively 61.59% ,69. 84% and 67. 86% ,which were equal among the three groups. The pregnancy loss rate of group A, B and C after therapy were respectively 22.08% ,46. 15%, 36. 36% ,which was lower in group A than group B（P 〈 0. 05）, and equal between group A and C, group B and C. Conclusion The influence of anti-β2-glyeoprotein I antibodies on pregnancy loss rate was equal to ACA. Patients of APS who had both positive anti-β2-glycoprotein I antibodies and ACA were poorly reactive to immunoregulatory therapy.