抗磷脂抗体对妊娠丢失筛查的临床价值

Clinical value of antiphospholipid antibody in the screening for pregnancy loss

目的探讨妊娠丢失与抗磷脂抗体（APA）[包括抗心磷脂抗体（ACA）和狼疮抗凝抗体（LA）]的关系。方法观察组为150例有妊娠丢失史的患者，其中分为胚胎停育组（36例）、死胎组（44例）和复发性流产组（70例）。对照组为同期120例正常孕妇，分别测定观察组和对照组静脉血清APA水平，并进行对比分析。结果整个观察组APA、ACA、LA的阳性率均高于对照组，差异有统计学意义（P〈0．05）。胚胎停育组与对照组比较，差异无统计学意义（P〉0．05）。死胎组和复发性流产组的APA、ACA、LA阳性率分别与对照组比较，差异均有统计学意义（P〈0．05）。结论APA与妊娠丢失有关，尤其对于复发性流产和死胎者。因此，对有不良孕产史的患者常规筛查APA，有利于尽早对因治疗。

Objective To investigate the relationship between history of pregnancy loss and antiphospholipid antibodies （ APA）, including anticaMiolipin （ ACA ） and lupus anti-coagulant antibodies （LA）. Methods One hundred and fifty patients with history of unexplained pregnancy loss as study group and 120 normal nonpregnant women as control group. The study group was further divided into three subgroups： embryo growth arrest （n = 36）, stillbirth （n = 44）, and recurrent abortion （n = 70） levels of serum APA（ including ACA and LA） were determined repectively and analyzed. Results The positive rates of APA, ACA, LA in the study group were significantly higher than those in control group （P 〈 0. 05 ）. The above significance was true in both stillbirth and recurrent abortion groups but not in embryo growth arrest group. Conclusions Levels of serum APA are associated with pregnancy loss, especially about recurrent abortion and stillbirth. We suggest routine screening of serum APA should be performed in patients with history of fetal wastage for the sake of early treatment.