封闭抗体在不同孕育状态妇女中的分布规律

The study on the distribution of block antibody among the women in different breed status

目的:观察封闭抗体在正常生育、早初孕及孕育不良妇女人群中的分布,探讨早初孕妇女封闭抗体的产生规律。方法:将514例患者分为健康早初孕、不明原因复发性自然流产(URSA)、继发性不孕、偶发性自然流产、正常生育产后妇女共5组。应用ELISA法检测各病例组血清中的封闭抗体(black antibody,BA)定性和定量结果。结果:BA的阳性率分别是:早初孕组50.9%(108/212),URSA组26.8%(22/82),继发不孕组42.9%(48/112),偶发性自然流产组70.4%(38/54),产后组88.9%(48/54);各组BA阳性率总体差异有统计学意义(χ2=61.265,P<0.001),早初孕组与URSA组(χ2=13.940,P<0.001)、产后组(χ2=25.551,P<0.001)比较差异亦有统计学意义,与继发性不孕(χ2=1.919,P=0.166)和偶发流产组(χ2=6.560,P=0.014)的差异无统计学意义。早初孕组妇女在5、6、7、8、9、10孕周BA的阳性率及BA定量结果秩均值分别是:52.2%、52.7;51.9%、57.4;54.2%、52.3;37.5%、51.9;61.5%、53.2;33.3%、43.5。早初孕组各孕周BA阳性率的差异无统计学意义(χ2=4.470,P=0.484);各孕周BA定量结果的差异无统计学意义(χ2=0.841,P=0.974)。早初孕组和产后组BA定量结果的秩均值分别是61.5和88.6,其差异有统计学意义(Z=-3.258,P=0.001)。结论:BA阳性率从高到低依次是:产后组、偶发性自然流产组、早初孕组、继发不孕组、URSA组。URSA的发生与BA的缺失有关,继发性不孕和偶发性自然流产与BA的缺失无相关性。随着妊娠的进行,封闭抗体的生成和浓度逐渐增强,在孕早期则保持相对稳定。

Objective： To study the distribution of block antibody among the women who were normal breed, early pregnant first time and bred badly. And to explore the law of block antibody in different breed women. Methods： A total of 514 cases from our hospital were collected and divided into early pregnancy first time group, unexplained recurrent spontaneous abortion （URSA） group, secondary in- fertility group, occasional spontaneous abortion group and normal reproductive women group. The qualitative and quantitative results of block antibody （BA） were tested by ELISA method. Results： The positive rate of BA in early pregnancy first time group, URSA group, secondary infertility group, occasional spontaneous abortion group and normal reproductive women group was respectively 50.9% （108/212）, 26.8% （22/82）, 42. 9% （48/112）, 70. 4% （38/54）, 88. 9% （48/54）. The overall difference in positive rate of BA in these groups was sig- nificant （X2 = 61. 265, P 〈 0. 001 ） ; the difference in positive rate of BA between the early pregnancy first time group and URSA group （X2 = 13. 940, P 〈0. 001 ） and normal reproductive women group （X2 =25. 551, P 〈0. 001 ） was significant, but no significant difference between the early pregnancy first time group and secondary infertility group （X2 = 1. 919, P =0. 166, P 〉0. 005） and occasional spontane- ous abortion group （X2 =6. 560, .P =0. 014, P 〉0. 005） . The positive rate of BA in the early pregnancy first time group from gestational week of 5, 6, 7, 8, 9, 10 and the rank values of BA was respectively 52.2%, 52.7; 51.9%, 57.4; 54.2%, 52.3; 37.5%, 51.9; 61.5%, 53.2; 33.3%, 43.5. The rank values of BA in the early pregnancy first time group and normal reproductive women group was respectively 61.5 and 88.6. No significant difference in positive rate of BA in gestation weeks of the early pregnancy first time group （X2 =4. 47, P =0. 484, P 〉 0. 05） . The quantitative results of BA in gestation weeks had no statistically significant （X2 = 0. 841, P = 0. 974, P 〉 0. 05） . The difference in quantitative results of BA between the early pregnancy first time group and normal reproductive women group was significant （Z = - 3. 258, P 〈0. 005） . Conclusion： The order from high to low of positive rate of quantitative results of BA is respectively normal reproductive women group, occasional spontaneous abortion group, early pregnancy first time group, secondary in- fertility group and URSA group. The missing of BA is relevant to the occurrence of URSA, and no obvious relevance to secondary infertility and occasional spontaneous abortion. As the pregnancy progresses, the formation and concentration of block antibody is progressive enhance- ment, and remained relatively stable in the early gestation.