抗心磷脂抗体在病理妊娠中的意义

Clinical value of a Aaticardiolipin Antibodies and pathologic pregnancy

目的 :探讨抗心磷脂抗体与病理妊娠的关系。方法 :对 447例行抗心磷脂抗体金标免疫斑点定性试验的病人及孕产妇行对照研究。结果 :①各病理妊娠组ACA阳性率明显高于正常妊娠组 ,其中流产、胎膜早破 ;妊娠合并肝内胆汁淤积症 ;胎儿宫内发育迟缓 ;死胎、早产 ;妊娠合并血小板减少的阳性率明显高于正常妊娠组 ,且统计学上有显著差异 (P <0 .0 5 ) ,而妊娠高血压综合征、胎儿畸形、妊娠剧吐、妊娠合并乙肝较正常对照无统计学意义 (P >0 .0 5 )。②研究抗心磷脂抗体与既往流产史的关系发现有流产史者较无流产史者显著增高。(P <0 .0 5 )。结论 :①抗心磷脂抗体阳性与流产、胎膜早破、早产、死胎、胎儿宫内窘迫有关。②有流产史者抗心磷脂抗体可增高。③抗心磷脂抗体阳性与妊娠高血压综合征的发病可能无关。

Objective: To investigate the relationship between anticardiolipin antibodies (ACA)and pathologic pregnancy.To show the clinical value of anticardiolipin antibodies on pathologic pregnancy. Methods: Levels of serum ACA were determined by gold marked immunoblot assay in 382patients (study group) and 65 normal pregnant women (control group) Results 1. The positive rates of ACA in study group were higher than in controls. The positive rates of ACA were significantly higher in abortion ,premature ruoture of membranes (PROM), intrahepatic cholestasis of pregnancy (ICP) , fetal death , premature delivery, pregnancy concurrent thrombocytopenia than those of controls(P<0.05), but there were no significant differences with those of pregnancy induced hypentension sysdrome (PIH ) and fetal abnormality(P>0.05). The positive rates of ACA were significantly lower in pregnancy complicated with hepatitis B . 2.There were higher positive rates of ACA in pregnant women who have a history of abortion than those not have (P<0.05). conclusion 1.ACA can induce abortion, premature labor , PROM, IUGR, and fetal death. 2.There are higher positive rates in pregnant women who have a history of abortion. 3. The levels of serum ACA could not associated with PIH.