不明原因不孕患者血清中抗核抗体、抗心磷脂抗体和抗β_2糖蛋白I抗体的检测价值

Detective value of anti-nuclear antibodies,anti-cardiolipin antibodies and anti-β_2 glycoprotein Ⅰ antibodies in serum among unexplained infertility patients

目的 探讨抗核抗体（ANA）谱、抗心磷脂抗体（aCL）和抗β2糖蛋白I抗体（aβ_2-GPI）是否可作为不明原因不孕（UI）患者行体外IVF-ET前病因筛查的检测指标。方法 收集2015年1月～4月在本院生殖医学中心接受IVF-ET标准方案的UI患者（UI组,108例）和正常已孕妇女（对照组,24例）为研究对象,收集血清,采用多重微珠免疫法检测ANA谱,酶联免疫吸附法检测aCL和aβ_2-GPI抗体。结果 UI组ANA总阳性率为14.8%（16/108）,而对照组无一例阳性,两组比较差异有统计学意义（P〈0.05）;UI组aCL总阳性率为38.0%（41/108）,显著高于对照组[8.3%（2/24）],差异有统计学意义（P〈0.05）;UI组aβ2-GPI总阳性率为9.3%（10/108）,高于对照组[8.3%（2/24）],但差异无统计学意义（P〉0.05）。结论ANA和aCL阳性可能是引起不明原因不孕的重要因素,检测两者水平将有助于分析其病因并给予恰当的治疗。

Objective：To explore whether the antinuclear antibodies（ANA）,anticardiolipin antibody（aCL）and anti-aβ2-glycoprotein I antibodies（aβ2-GPI）can be used as detection index of the etiology among the patients with unexplained infertility（UI）before IVF-ET.Methods：Multiplexed microparticle-based immunoassay was used to detect ANA,and enzyme-linked immunobsorbent assay（ELISA）was used to determine aCL and aβ2-GPI in 108 patients with UI and 24 normally fertile women.Results：The total positive rate of ANA was 14.8%（16/108）in UI patients,while 0% in control group.There was significant difference between UI and control groups（P〈0.05）.The total positive rate of aCL was 38.0%（41/108）in UI patients and 8.3%（2/24）in control group.There was significantly difference between UI and control groups（P〈0.05）.The total positive rate of aβ2-GPI was 9.3%（10/108）in UI group and 8.3%（2/24）in control group.There was no statistical significance between the two groups（P〉0.05）.Conclusions：The results suggest that positive ANA and aCL may be the important immune factors causing UI,and detection of these antibodies may be helpful for analyzing the etiology and providing appropriate treatment.