抗核抗体检测在不孕诊断中的价值

Role of antinuclear antibody determination in the diagnosis of infertility

目的通过对不孕妇女抗核抗体(ANA)检测结果的分析,探讨ANA诊断不孕症的价值。方法采用间接免疫荧光法(IIF)测定2 939例不孕妇女(实验组)与同期无不良孕产史的308名健康育龄妇女(对照组)的ANA,采用免疫印迹法(LIA)测定其ANA谱。比较2个组检测结果,分析自身抗体与不孕的关系。结果实验组中检出ANA阳性316例,阳性率为10.75%;对照组检出ANA阳性6例,阳性率为1.95%。实验组与对照组ANA阳性滴度占比最高均为1∶100。实验组常见ANA核型为颗粒型(64.24%)、核仁型(19.31%);对照组常见ANA核型为颗粒型(83.33%)、均质型(16.67%)。实验组ANA谱检测,各类抗体均有检出,抗SS-A抗体检出率最高(23.03%),ANA阴性者也有ANA谱检出,各抗体类型阳性率不同。ANA与ANA谱联合检测,实验组阳性率为20.42%,对照组阳性率为6.49%,差异有统计学意义(P<0.05)。结论 ANA是不孕的病因之一,ANA与ANA谱联合检测诊断不孕症的价值优于单独检测。

Objective To analyze the determination results of antinuclear antibodies(ANA)in infertile female patients,and to investigate the role of ANA determination in the diagnosis of infertiliy.Methods A total of2939infertile patients(infertile group)were enrolled and determined for ANA by indirect immunofluorescence,and their ANA profiles were determined by immunoblotting.The results were compared with those of healthy women(control group)at reproductive age who had no history of adverse pregnancy during the same period.The relationship between autoantibodies and infertility was analyzed.Results In infertile group,316cases of ANA were determined,and the positive rate was10.75%.There were6cases of ANA in control group,and the positive rate was1.95%.The median of ANA in infertile group was1∶100,which was lower than the median of ANA positive titers for autoimmune diseases.The common ANA karyotypes in infertile group were granular(64.24%)and nucleoli(19.31%).The common ANA karyotypes in control group were granular(83.33%)and homogenized(16.67%).For ANA profile in infertile group,all kinds of antibodies were determined,anti-Sj?gren syndrome A(SS-A)antibody was the most(23.03%),and ANA profile was also determined in ANA negative patients.Using ANA combined with ANA profile,the positive rate in infertile group was20.42%,and that in control group was6.49%(P>0.05).Conclusions ANA is one of the causes of infertility.The combined determination of ANA and ANA profile is better than single determinations in the diagnosis o f infertility.