抗核抗体与不明原因复发性流产患者再次妊娠结局的相关性研究

Correlation between Antinuclear Antibodies and Pregnancy Outcome in Patients with Unexplained Recurrent Miscarriage

目的抗核抗体(ANA)与复发性流产及其再次妊娠结局的关系仍存在争议。本研究旨在分析抗核抗体对于不明原因复发性流产(uRM)女性再次妊娠结局的影响。方法回顾性分析2016年1月～2018年1月于我院住院保胎的uRM患者222例,采用间接免疫荧光法(IIF)检测血清中ANA滴度,以首次就诊时ANA检测结果分为两组:ANA阴性组152例,ANA阳性组70例。比较ANA与流产率的相关性。结果不明原因复发性流产ANA阳性组流产率为35.71%,明显高于ANA阴性组(P=0.003),两组早期流产率并无统计学差异(P=0.1160)。而在晚期流产中,ANA阳性组流产率明显高于ANA阴性组(P=0.006),两组的流产孕周无显著差异(P>0.05)。ANA阳性组中滴度1:100组有40例,流产发生率22.25%(9例);1:320组有27例,流产发生率48.15%(13例);1:1000组有3例,流产发生率100%(3例)。ANA滴度与uRM患者再次妊娠发生流产的概率存在正相关性(P=0.0019)。结论本研究结果表明ANA与uRM患者再次妊娠的妊娠结局具有临床相关性,可能是uRM再次妊娠患者晚期流产的重要不利因素。

Objective The relationship between antinuclear antibodies (ANA) and recurrent miscarriage remains controversial.This study was designed to analyze antinuclear antibodies to the pregnancy outcomes in women with unexplained recurrent miscarriage (uRM).Methods A retrospective analysis of 222 patients with uRM who were hospitalized in our hospital from January 2016 to January 2018 was performed. Indirect immunofluorescence (IIF) was used to detect ANA titer in serum.All the patients were divided into two groups by the ANA titer at first visit :152 patients in the ANA negative group and 70 patients in the ANA positive group.The correlation between ANA and abortion rate of pregnant women with uRM was compared. Results The abortion rate of ANA positive group in unexplained recurrent miscarriage was 35.71%,which was significantly higher than ANA negative group (P=0.003).There was no significant difference abortion rate in first trimester between the two groups (P=0.1160).However,in the third trimester,the abortion rate of the ANA positive group was significantly higher than that of the ANA negative group (P=0.006).But there was no significant difference in the gestational age between the two groups (P>0.05).there were 40 patients in the 1:100 group,the incidence of abortion was 22.25%(9 cases);the 1:320 group had 27 cases,the incidence of abortion100%(3 cases).There was a positive correlation between the ANA titer and pregnant outcome in uRM patients (P = 0.0019).Conclusions This study suggest that there is a clinical association between ANA and the pregnancy outcome in women with unexplained recurrent miscarriage,which may be an important adverse factor.