血清ACA、抗β2-GPⅠ抗体水平与不良妊娠结局的关系研究

The Relationship Between Levels of Serum ACA and Anti-β2-GP I Antibody and Adverse Pregnancy Outcomes

目的探究血清抗心磷脂抗体(ACA)、抗β2-糖蛋白Ⅰ抗体(anti-β2-GPⅠ)与不良妊娠结局的相关性。方法回顾性分析171例孕妇临床资料,根据妊娠结局分为不良组(n=29)与良好组(n=142)。比较两组孕妇血清ACA-免疫球蛋白(Ig)A、ACA-IgG、ACA-IgM及anti-β2-GPⅠ-IgA、anti-β2-GPⅠ-IgG、anti-β2-GPⅠ-IgM水平差异,以Spearman相关系数模型分析上述指标与不良妊娠结局的相关性,采用受试者工作特征(ROC)曲线评估相关性指标对不良妊娠结局的预测效能。结果不良组孕妇血清ACA-IgA、ACA-IgG、ACA-IgM及anti-β2-GPⅠ-IgA、anti-β2-GPⅠ-IgG、anti-β2-GPⅠ-IgM水平均明显高于良好组(P<0.05)。孕期血清各类ACA、抗β2-GPⅠ抗体水平均与不良妊娠结局呈显著正相关性(r>0,P<0.05),且预测不良妊娠结局ROC曲线下面积(AUC)均明显大于参考线,且均明显小于联合预测曲线(P<0.05)。结论孕期检测血清ACA、抗β2-GPⅠ抗体可对孕妇不良妊娠结局作出早期预警,联合检测可取得良好预测效果,尽早指导临床开展相关防治措施。

Objective To investigate the correlation between levels of serum anticardiolipin antibody(ACA)and anti-β2-glycoprotein I antibody(anti-β2-GPI)and adverse pregnancy outcomes.Methods The clinical data of 171 pregnant women were retrospectively analyzed.According to the pregnancy outcomes,they were divided into the poor group(n=29)and good group(n=142).The levels of serum ACA-immunoglobulin(Ig)A,ACA-IgG,ACA-IgM and anti-β2-GP I-IgA,anti-β2-GP I-IgG and anti-β2-GP I-IgM were compared between the two groups.Spearman correlation coefficient model was used to analyze the correlation between the above indicators and adverse pregnancy outcomes,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of relevant indicators on adverse pregnancy outcomes.Results The levels of serum ACA-IgA,ACA-IgG,ACA-IgM and anti-β2-GP I-IgA,anti-β2-GP I-IgG and anti-β2-GP I-IgM in the poor group were significantly higher than those in the good group(P<0.05).The levels of serum ACA and anti-β2-GP I antibody during pregnancy were significantly positively correlated with adverse pregnancy outcomes(r>0,P<0.05),and the area under the ROC curve(AUC)for predicting adverse pregnancy outcomes was significantly larger than the reference line(P<0.05).Conclusion Detection of serum ACA and anti-β2-GPI antibody during pregnancy can provide the early warning of adverse pregnancy outcomes in pregnant women,and guide clinical implementations of relevant prevention and treatment strategies in a timely manner.