孕晚期妇女自身抗体发生率及量值检测分析

The analysis to the prevalence and quantitative level of autoantibodies in the late trimester of pregnancy

目的采用化学发光法(CLIA)对孕晚期妇女开展自身抗体定量检测,分析各抗体的发生率及量值水平。方法以82例甲状腺功能减退、肝功能异常和妊娠糖尿病的孕晚期妇女为病例组,100例健康孕晚期妇女为对照组,应用CLIA开展抗核糖核蛋白(RNP)抗体、抗史密斯(Sm)抗体、抗干燥综合征抗原A(SSA)抗体、抗干燥综合征抗原B(SSB)抗体、抗硬皮病70(Scl-70)抗体、抗组胺酰tRNA合成酶抗原(Jo-1)抗体、抗dsDNA抗体、抗心磷脂(Cal)抗体及抗β2糖蛋白1型(β2GPⅠ)抗体定量检测。结果不同年龄段孕晚期妇女及具备不同临床表现(包括甲状腺功能减退、肝功能异常和妊娠糖尿病等)的孕晚期妇女间自身抗体发生率比较,结果显示差异无统计学意义(P>0.05)。抗SSA抗体IgG和抗Cal抗体IgM表现出较高的发生率和量值水平,提示上述两种抗体对于产前自身抗体筛查具有重要的意义和价值。结论抗SSA抗体IgG和抗Cal抗体IgM在孕晚期妇女中具有较高的抗体发生率及量值水平,可作为孕晚期妇女自身抗体筛查的重点检测项目。

Objective To investigate the prevalence and quantitative level of autoantibodies in the late tri-mester of pregnant women with chcmiluminesccnt immunoassay （CILIA）. Methods 82 pregnant women with at least one sign of hypothyroidism,hepatic dysfunction and gcstational diabetes in the latc trimester, of preg- nancy were constituted ,he cases and 100 normal pregnant women as controls. All sera were tested quantita- tively with CLIA for autoantibodies to RNP,Sm,SSA,SSB,Scl-70,Jo-1 ,double stranded DNA （ds-DNA）,car- diolipin（Cal） and 132 glycoprotein I antibody （β2GP I ）. Results The positive rate of antibody was neither relevant with age nor with clinical manifestation,including hypothyroidism, hepatic dysfunction and gestational diabetes,the difference was not statistically significant （P〉0.05）. Among all tested antibodies,anti-SSA IgG and anti-Cal IgM not only showed the highest positive rate, but also maintained in a relatively high median lev- el, which indicated these two antibodies may play an important role in screening the undiagnosed rheumatic disease in pregnant women. Conclusion Bo,h anti-SSA and anti-Cal IgM showed ,he highest post,lye ra,c and antibody level in the late trimester pregnancy,these two antibodies should be considered as the utmost impor- tant parameter for screening the undiagnoscd rhcuma,ic disease in pregnant women.