封闭抗体缺失与不同类型复发性自然流产关系分析

Analysis of the Correlation between the Lack of Antipaternal Lymphocyte Antibody and Recurrent Spontaneous Abortion

目的:研究复发性自然流产(RSA)与封闭抗体的关系,探讨封闭抗体检测的临床意义。方法:采用酶联免疫吸附试验(ELISA)检测389例RSA患者和50例正常孕妇血清的封闭抗体抗丈夫淋巴细胞抗体(APLA),并且比较不同类型流产APLA阴性率的差异;同时利用G显带技术对稽留流产组130例患者绒毛染色体分析。结果:RSA患者APLA阴性率为86.63%,明显高于对照组的阴性率28.00%,差异有统计学意义(P<0.01)。难免流产组患者APLA的阴性率为94.59%,稽留流产组阴性率为70.77%,两者差异有统计学意义(P<0.01);稽留流产组绒毛染色体异常率为52.31%。结论:RSA与患者封闭抗体缺失有关,其中封闭抗体缺失在难免流产患者中缺失更为明显。在RSA患者中及时进行封闭抗体的检测,对于RSA的实验室诊断及免疫治疗非常重要,稽留流产患者在检测封闭抗体的同时,分析绒毛染色体尤为重要。

Objective：To study the relationship between the recurrent spontaneous abortion（RSA）and the lack of antipaternal lymphocyte antibody（APLA）in patients and the difference of APLA′s negative rate between the inevitable abortion and missed abortion patients;To explore the clinical significance of APLA combined with the results of chromosome analysis.Methods：APLA was detected by enzyme-linked immunosorbent assay（ELISA）in 389 patients with RSA and 50 normal controls to compare missed rate of APLA in the different clinical types of RSA;G-banding technique and karyotype analysis were performed on 130 sample of missed abortion.Results：The negative rate of APLA in patients with RSA（86.63%）was significantly higher than that of the controls（28.00%）,and the difference was statistically significant（P〈0.01）.The negative rate of APLA in patients with inevitable abortion（94.59%）was significantly higher than that of patients with missed abortion（70.77%）,there was a statistically significant difference between them（P〈0.01）;The rate of the abnormal chorion chromosome in missed abortion group was 52.31%.Conclusions：Lack of APLA maybe related to recurrent spontaneous abortion,and the deficiency of APLA in patients with inevitable abortion is more significant.It is very important to timely detect ALPA for laboratory diagnosis and immunotherapy of abortion patients.For the missed abortion patients,the chromosome analysis of villus is particularly necessary.