化学发光法检测女性自身免疫生殖相关抗体的临床应用评价

Clinical evaluation of chemiluminescence detection of female autoimmune reproductive related antibodies

目的:研究自身免疫抗体在女性生殖相关疾病诊断中的应用价值。方法:选择卵巢早衰(Premature Ovarian Failure,POF)患者30例、多囊卵巢综合征(Polycystic Ovarian Syndrome,PCOS)患者30例、子宫内膜异位症患者40例、不孕不育患者80例以及健康女性50例;采用化学发光检测技术检测这230例血清样本中的抗精子抗体[anti sperm antibody,ASA(IgG/IgM)]、抗卵巢抗体[anti ovarian autoantibody,AOA(IgG/IgM)]、抗子宫内膜抗体[endometrial antibody,EMAb(IgG/IgM)]和抗透明带抗体[zona pellucida antibodies,ZPAb(IgG/IgM)];用数据处理统计软件MedCalc分析每个检测项目数据。结果:在2%的健康人群血清中查出了IgG抗体,但没查出IgM抗体。AOA(IgG/IgM)检测对POF和PCOS诊断有指导意义。在POF患者样本中,AOA(IgG/IgM)的阳性率为66.7%,显著高于健康人样本的检出率2%(P<0.001),在PCOS患者样本中的阳性率为36.7%,同样显著高于健康人样本的检出率(P<0.001)。EMAb和子宫内膜异位症有很高的相关性,联合检测IgG分型和IgM分型在阳性组的检出率为57.5%,显著高于健康人样本的检出率2%(P<0.001)。联合检测ASA(IgG/IgM)、AOA(IgG/IgM)、EMAb(IgG/IgM)和ZPAb(IgG/IgM)分析80例不明原因不孕患者样本,阳性检出率为30%,显著高于健康人样本的检出率4%(P<0.001)。结论:采用化学发光法检测ASA、AOA、EMAb、ZPAb对POF、PCOS、子宫内膜异位症和女性不孕不育症等疾病的临床诊断有重要指导意义。

Objective:To evaluate the clinical performance of autoimmune antibodies in the diagnosis of diseases related to female reproduction.Methods:A total of 230 sera were tested in this study,including 30 samples from patients with premature ovarian failure(POF),30 smaples from patients with polycystic ovary syndrome(PCOS),40 samples from patients with endometrial displacement,80 samples from patients with infertility and 50 healthy controls.Serum IgG/IgM antibodies against sperm,ovary,endometrium,zona pellucida(ASA,AOA,EMAb,ZPAb)were determined by chemiluminescence assays.The data processing and statistical software MedCalc was utilized for all statistical tests.Results:IgG autoimmune antibodies were detected in 2%healthy controls,but none of IgM antibodies were detected.AOA(IgG/IgM)detection has guiding significance in the diagnosis of POF and PCOS.The positive rate of total AOA-IgG and AOA-IgM in POF patients was 66.7%,significantly higher than that in healthy people(2%)(P<0.001).Also,the positive rate of AOA(IgG/IgM)in PCOS patients was 36.7%,significantly higher than that in healthy people(P<0.001).The autoimmune antibodies against endometrium demonstrated good correlation with endometriosis.The positive rate 57.5%of EMAb-IgG and EMAb-IgM was obtained in positive group,significantly higher than that in the healthy people(2%)(P<0.001).80 samples from patients with unexplained infertility were analyzed by combined detection of ASA(IgG/IgM)、AOA(IgG/IgM)、EMAb(IgG/IgM)and ZPAb(IgG/IgM),the total positive rate was 30%,significantly higher than the detection rate of 4%in healthy samples(P<0.001).Conclusion:Our data suggest chemiluminescence assays have good performance in detecting ASA,AOA,EMAb and ZPAb for the diagnosis of POF,PCOS,endometriosis and female infertility.