产科抗磷脂综合征诊治现状与研究进展

Diagnosis and treatment status and research progress of the obstetric antiphospholipid syndrome

抗磷脂综合征(antiphospholipid syndrome,APS)是一种自身免疫性疾病,可累及多器官及多系统。在妊娠期间由于孕妇血流动力学的改变,一旦合并APS可使机体处于高凝状态,因此极易发生胎盘血栓形成。同时抗磷脂抗体(antiphospholipid antibody,aPL)可通过破坏滋养细胞功能等多种机制造成子痫前期、胎儿生长受限、胎儿宫内死亡及其他不良结局。APS患者一旦发生产科合并症则被称为产科抗磷脂综合征(obstetric APS,OAPS)。本文就OAPS的诊断及分型、与不良妊娠结局的相关性、诊治现状及远期随访进行文献综述,以期为临床工作提供指导。

Antiphospholipid syndrome(APS)is an autoimmune disease affecting multiple organs and systems.The combination of APS with maternal hemodynamic changes during pregnancy can put the body in a hypercoagulable state,making it highly susceptible to placental thrombosis.In addition,the effect of antiphospholipid antibody(aPL)on trophoblast cell function can cause preeclampsia,fetal growth restriction,intrauterine fetal death,and other adverse outcomes.It is called obstetric antiphospholipid syndrome(OAPS)when patients with APS develop obstetric complications.This article provides a literature review on the diagnosis and staging of OAPS,the correlation with adverse pregnancy outcomes,the current status of diagnosis and treatment,and long-term follow-up,with the aim of providing guidance for clinical work.