复发性流产患者甲状腺抗过氧化物酶抗体和抗心磷脂抗体阳性对受孕能力及早期妊娠结局的影响

Effect of Thyroid Peroxidase Antibody and Anticardiolipin Antibodies on Ability to Conceive and Early Pregnancy Outcome in Patients with Recurrent Spontaneous Abortion

目的:探讨复发性流产(RSA)患者甲状腺抗过氧化物酶抗体(TPOAb)、抗心磷脂抗体(ACA)对受孕能力、早期妊娠结局的影响。方法:以2010年7月至2013年2月非妊娠RSA患者183例为研究对象,根据首诊时检测的ACA和TPOAb阳性情况分为ACA阳性组(组I,n=75)、ACA和TPOAb均阳性组(组Ⅱ,n=27)、TPOAb阳性组(组Ⅲ,n=81),比较1年内三组受孕能力及早期妊娠结局。结果:组l的自然妊娠率和早期妊娠成功率均显著高于组Ⅱ和组Ⅲ(P均<0.001)。结论:在ACA阳性RSA患者中,常并存TPOAb阳性,且与受孕能力下降、自然流产存在明显关系,建议对RSA患者常规行甲状腺自身抗体检测。

Objective： To explore the effect of thyroid peroxidase antibody（TPOAb）and anticardiolipin antibodies （ACA）on ability to conceive and early pregnancy outcome in patients with recurrent spontaneous abortion （RSA）. Methods：IS3 non-pregnant women affected with RSA from Jul 2010 to Feb 2013 were divided into ACA positive group （group Ⅰ, n=75 ）, both TPOAb and ACA positive group （group Ⅱ, n=27 ）, TPOAb positive group （group Ⅲ, n=81 ） according to the positive of ACA and TPOAb detected at first diagnose ,and the abihty to conceive and early pregnancy outcome were compared among the three groups. Results：The rates of natural pregnancy and early pregnancy success in group I were significantly higher than those in group Ⅱ and group Ⅲ （both P〈0.001）. Conclusion： TPOAb is frequently present in ACA recurrent aborters and is often associated with either reduced fecundity or with poor early pregnancy outcome. Thyroid antibodies should be detected in patients with RSA.