血清细胞因子在复发性流产患者血清中的表达及临床意义  

Clinical significance of serum cytokine in women with recurrent spontaneous abortion

作　　者：邹亦庐[1] 江丽[2] 吴建波[1] 陈丽红[1] 胡继芬[1] 林彤[3] 陈剑峰 ZOU Yi - lu;JIANG Li;WU Jian - bo;CHEN Li - hong;HU Ji -fen;LIN Tong;CHEN Jian - feng(a Department of Gynaecology and Obstetrics;b. Department of Clinical Laborator;a Department of Reproduction Center, The First Affiliated Hosphal of Fujian Medical University, Fuzhou 350005, China)

机构地区：[1]福建医科大学附属第一医院妇产科,福州350005 [2]福建医科大学附属第一医院检验科,福州350005 [3]福建医科大学附属第一医院生殖中心,福州350005

出　　处：《中国临床药理学杂志》2018年第13期1511-1513,共3页The Chinese Journal of Clinical Pharmacology

基　　金：福建省教育厅科技基金资助项目(JS08012)

摘　　要：目的观察血清抗精子抗体(ASAb),血清抗心磷脂抗体(ACA)及抗β2糖蛋白抗体Ⅰ(A-β2-GPI)在复发性流产(RSA)患者中的表达及临床意义。方法入选我院收治的复发性流产患者66例为试验组,选取同期正常生育者45例为对照组。用间接免疫荧光法检测2组的血清ASAb表达水平,用酶联免疫吸附(ELISA)法检测抗心磷脂抗体-免疫球蛋白M(ACA-Ig M)、抗心磷脂抗体-免疫球蛋白G(ACA-Ig G)及A-β2-GPI水平;用受试者工作特征曲线(ROC)评估血清ASAb、ACA-Ig M、ACA-Ig G及A-β2-GPI预测复发性流产的应用价值。结果试验组和对照组As Ab阳性率分别为13.64%(9例/66例)和2.22%(1例/45例),差异有统计学意义(P<0.05)。试验组ACA-Ig M及A-β2-GPI含量分别为(6.78±4.57)U·m L^(-1)和(17.16±28.67)RU·m L^(-1),对照组分别为(2.98±2.570)U·m L^(-1)和(3.31±2.86)RU·m L^(-1),差异有统计学意义(P<0.05)。试验组和对照组ACA-Ig G含量分别为(2.39±1.75),(2.14±1.34)U·m L^(-1),差异无统计学意义(P>0.05)。血清ACA-Ig M、ACA-Ig G及A-β2-GPI预测RSA的敏感性分别为80.01%,71.13%和95.58%;特异性分别为69.72%,38.51%和83.26%;ROC曲线下面积分别为0.78,0.56和0.95。试验组血清ACA-Ig M与ACA-Ig G(rpearson=0.66,P<0.05),ACAIg M与A-β2-GPI(rpearson=0.75,P<0.05)和ACA-Ig G与A-β2-GPI(rpearson=0.38,P<0.05)存在明显的相关性。结论血清As Ab、ACA-Ig M和A-β2-GPI与复发性流产有关,其血清高表达提示复发性流产风险较高。Objective To evaluate the clinical significance of antisperm antibody（ ASAb）,anticardiolipin antibody（ ACA）,anti-β2-glycosprotein I and body（ A-β2-GPI） in women with recurrent spontaneous abortion. Methods Sixty-six recurrent spontaneous abortion（ RSA）patients（ treatment group） and 45 healthy pregnant women（ control group） were included. The serum levels of ASAb,ACA and A-β2-GPI were examined between treatment group and control group. The diagnostic value of serum ASAb,ACA and A-β2-GPI were evaluated by bias theorem and the correlation among them was evaluated by Pearson correlation test. Results The ASAb positive rates were 13. 64%（ 9 cases/66 cases） and 2. 22%（ 1 cases/45 cases） in treatment group and control group,with significant difference（ P〈0. 05）. The serum levels ofACA-immunoglobulins M（ Ig M） and A-β2-GPI in treatment group were（ 6. 785 ± 4. 57） U · m L-1 and（ 17. 16 ± 28. 67） RU·m L-1,had significant difference with those in control group,which were（ 2. 98 ± 2. 570）U·m L-1,（ 3. 31 ± 2. 86） RU·m L-1（ P〈0. 05）. The serum levels of ACA-immunoglobulins G（ Ig G） in treatment group and control group were（ 2. 39 ± 1. 75）,（ 2. 14 ± 1. 34） U·m L-1,with no significant difference（ P〈0. 05）. The prediction sensitivity were 80. 01%,71. 13% and 95. 58%,the prediction specificity were 69. 72%,38. 51% and83. 26% for serum ACA-Ig M,ACA-Ig G and A-β2-GPI respectively. The AUC were 0. 78,0. 56 and 0. 95 for serum ACA-Ig M,ACA-Ig G and A-β2-GPI respectively. Significant correlation were found among serum ACA-Ig M,ACA-Ig G and A-β2-GPI（ P〈0. 05）. Conclusion Serum ASAb,ACA-Ig M,ACA-Ig G and A-β2-GPI are related to RSA. The high level of ACA-Ig M and β2-GPI can be prediction biomarker for RSA.

关 键 词：复发性自然流产 抗心磷脂抗体 抗精子抗体 

分 类 号：R97[医药卫生—药品]