抗子宫内膜抗体和抗精子抗体对不孕者和习惯性流产者的检测及临床探讨

Detection and clinical discussion of the EMAB and ASAB to the infertility,habitual abortion

目的:探讨抗子宫内膜抗体(EMAB)和抗精子抗体(ASAB)对不孕者和习惯性流产的关系。方法:用酶联免疫吸附试验(ELISA)法对168例不孕者和168例习惯性流产者进行了抗子宫内膜抗体和抗精子抗体检测并分析其与习惯性流产的关系,同时与正常对照者作对比研究。结果:习惯性流产者EMAB阳性率为40.5%(68/168),ASAB 15%(3/20),总阳性率为30%(6/20)经统计学处理,(χ2=3.88,P<0.05),不孕者EMAB阳性率为47.6%(80/168),ASAB5.9%(10/168),总阳性率为53.6%(90/168),对照组EMAB15%(3/20),ASAB 5%(1/20)总阳性率为20%(4/20),经统计学处理不孕者EMAB阳性率P>0.05,AS-AB阳性率P<0.05,ASAB阳性率P<0.01,习惯性早期流产(孕龄<12周)患者EMAB和ASAB阳性率分别为9.8%(12/123)ASAB阳性率为44.7%(55/123)明显高于晚期流产者(孕龄≥12周,P<0.05)。结论:EMAB和ASAB与子宫内膜发生抗原抗体反应,干扰受精卵的着床和发育,导致不孕,故检测EMAB和ASAB对不孕者和习惯性流产的诊断和预后具有极其重要的价值。

Objective To study the relationship between anti - endometrial antibody （ EMAB）, anti - sperm antibodies （ASAB） and the infertility,habitual abortion. Method We used enzyme- linked immunosorbent assay （ELISA） method on 168 cases of infertility and 168 cases of habitual abortionto detect the anti -endometrial antibody and anti -sperm antibody, and analyzed relationship between them and habitual abortion,and had comparative study with the normal controls. Results EMAB - positive rate of habitual aborter was 40. 5% （68/168）, ASAB was 15% （three- twentieths）, the overall positive rate was （30%） through statistical analysis, （X2 = 3. 88 ,P 〈 0. 05 ）. EMAB - positive rate of infertility was 47.6 % （ 80/168 ） , ASAB was 5.9 % （ ten - one hundred and sixty eighths）, overall positive rate was （53. 6% ）, the control group EMAB was 15% （3/20）, ASAB was5% （one -twentieth） overall positive rate was （20%） , By statistical a-nalysis of infertility EMAB positive rate of positive rate of positive rate of P 〉 0.05, ASAB P 〈 0. 05, ASA B P 〈 0. 01, Early habitual abor- tion （gestafional 〈 12 weeks） in patients with positive rate of ASAB and EMAB 9. 8% respectively （12/123） ASAB positive rates （44. 7% ）, significantly higher than the late abortion （gestational age ~〉 12 weeks,P 〈 0. 05 ）. Conclusion Antigen -antibody reaction be- tween ASAB and EMAB and endometrium, were interfered with implantation and development of the fertilized egg, and resulted in infertil- ity,so detection of ASAB and EMAB has paramount value on the diagnosis and prognosis of infertility and habitual abortion.