aCL、抗β2-GPⅠ、LA检测在妊娠合并抗磷脂综合征患者诊断中的应用价值

The value of aCL, anti-β2-GPⅠ, LA detection in the diagnosis of pregnant women with antiphospholipid syndrome

目的探讨分析aCL、抗β2-GPⅠ和LA等3种抗磷脂抗体(aPLs)在妊娠合并抗磷脂综合征(APS)患者诊断中的应用价值。方法将安徽中医药大学附属医院太和中医院2017年1月至2019年12月收治的80例妊娠合并APS患者作为观察组,选取同期80例健康体检孕妇作为对照组。在妊娠早期、中期、晚期及产后30~40 d四个时期,分别用酶联免疫吸附试验(ELISA)检测两组检测对象血清中的抗心磷脂抗体(aCL)和抗β2糖蛋白Ⅰ(抗β2GPⅠ)水平;用改良稀释蝰蛇毒时间法(dRVVT)检测狼疮抗凝物(LA)水平。结果观察组患者aCL、抗β2-GPⅠ和LA含量均显著高于对照组(P <0.05),且从妊娠早期到晚期,APS患者血清中的a CL、抗β2-GPⅠ、LA指标随孕期增加而逐渐升高,差异均有统计学意义(P <0.05)。结论 aCL、抗β2-GPⅠ、LA等a PLs参与了抗磷脂综合征的发病过程,且在妊娠各期表现出不同的临床分布特征,对判断APS患者妊娠结局具有重要的诊断价值。

Objective To explore the application value of three anti-phospholipid antibodies(aPLs) in the diagnosis of pregnant patients with antiphospholipid syndrome(APS). Methods 80 pregnant women with APS admitted to Taihe Hospital of Traditional Chinese Medicine, from January 2017 to December 2019 were taken as the observation group, and 80 healthy pregnant women during the same period were selected as the control group. During the first, second, third trimester and 30~40 days after birth correspondingly, enzyme-linked immunosorbent assay(ELISA) was used to detect the anticardiolipin antibodies(aCL) and anti-β2 glycoprotein I(anti-β2-GPⅠ);modified diluted viper venom time method(dRVVT) was used to detect the level of lupus anticoagulant(LA). Results The levels of aCL, anti-β2-GPⅠ, and LA in the observation group were significantly higher than those in the control group(P < 0.05). The serum levels of aCL, anti-β2-GP Ⅰ, LA in APS patients all increased as the gestational week increased, with statistically significant differences(P < 0.05). Conclusion The aPLs including aCL, anti-β2-GPⅠ, LA are involved in the pathogenesis of APS, and show different clinical distribution characteristics in each stage of pregnancy, which has important diagnostic value for judging the pregnancy outcome of APS patients.