ACA、αβ-GPI及AT-Ⅲ水平在不明原因复发性流产患者诊疗中的应用价值

Application value of ACA,αβ-GPI and AT-Ⅲ levels in patients with unexplained recurrent miscarriage in diagnosis and treatment

目的了解抗心磷脂抗体(ACA)、抗β2糖蛋白抗体I(αβ2-GPI)及抗凝血酶Ⅲ(AT-III)水平变化在不明原因复发性流产(recurrent spontaneous abortion,RSA)患者诊疗中的应用价值,为RSA诊疗提供参考依据。方法收集2017年7月~2018年12月来医院门诊妇科就诊并确诊为RSA未孕患者195例为RSA组,选择同期有正常分娩史的健康未孕妇女104名为对照组,分别采用酶联免疫吸附法(ELSIA)检测血清中ACA和αβ2-GPI 含量,同时采用发色底物法检测血浆中AT-III活性,并对结果进行统计处理。结果 RSA组未孕患者血清中ACA和αβ2-GPI水平分别为7.13±4.91U/ml和37.85±29.67RU/ml,明显高于对照组的3.04±1.62U/ml和8.29±3.74RU/ml,差异有统计学意义(t=4.0524~7.5167,P<0.05),而RSA未孕患者血浆中AT-III活性为75.28±4.73%,明显低于对照组妇女的94.16±5.66%,差异有统计学意义(t=3.9275,P<0.05);RSA未孕患者经治疗后血清中ACA和αβ2-GPI水平明显降低,与治疗前比较差异均有统计学意义(t=3.1073~5.6271,P<0.05),而血浆中AT-III活性明显升高,与治疗前比较差异有统计学意义(t=3.0725,P<0.05)。结论治疗前RSA未孕患者ACA和αβ2-GPI水平明显升高,AT-III活性明显下降,而治疗后ACA和αβ-GPI水平明显降低,AT-III活性明显升高。因此,ACA,αβ-GPI及AT-III水平监检在RSA患者的诊疗具有一定的应用价值,值得推广应用。

Objective:To understand the application value of levels changing of anti cardiolipin antibody(ACA),anti β2 glycoprotein antibodies I(αβ2-GPI)and anti thrombin III(AT-III)in patients with unexplained recurrent miscarriage(recurrent what abortion,RSA)in the diagnosis and treatment,provide reference basis for RSA diagnosis and treatment.Methods:From July 2017 to December 2018,195 patients admitted to the outpatient department of gynaecology of the hospital and diagnosed with RSA were included as RSA group,104 healthy women with a normal history of labor were selected as control group,respectively by using enzyme-linked immunosorbent(ELSIA)detection the levels of ACA and αβ2-GPI in serum,AT-III activity in plasma was detected by hair-color substrate assay,and the results are statistics processing.Results:The levels of ACA and αβ2-GPI in serum of RSA group were 7.13±4.91U/ml and 37.85±29.67RU/ml,respectively,which were significantly higher than 3.04±1.62U/ml and 8.29±3.74RU/ml of control group,and the difference was statistically significant(t=4.0524~7.5167,P<0.05),The activity of AT-III in plasma of RSA patients was 75.28±4.73%,significantly lower than 94.16 5.66% in the control group,The difference was statistically significant(t=3.9275,P<0.05);the levels of ACA and αβ2-GPI in serum were significantly decreased of RSA patients after treatment,and the difference was statistically significant(t=3.1073~5.6271,P<0.05),while the activity of AT-III in plasma was significantly increased,and the difference was statistically significant(t=3.0725,P<0.05).Conclusion:The levels of ACA and αβ2-GPI were significantly increased and AT-III activity was significantly decreased in RSA patients before treatment,while the levels of ACA and αβ2-GPI in serum were significantly decreased and AT-III activity was significantly increased after treatment.Therefore,ACA,αβ2-GPI and AT-III level surveillance have certain application value in the diagnosis and treatment of RSA patients,Worthy of promotion and application.