复发性流产患者抗磷脂抗体分布分析  

Distribution of antiphospholipid antibodies in patients with recurrent abortion

作　　者：董雪梅[1] 张翀[1] 马宁霞 赵盼 李亚娇 米乐园 尹姣姣 Dong Xue-mei∗;Zhang Chong;Ma Ning-xia;Zhao Pan;Li Ya-jiao;Mi Le-yuan;Yin Jiao-jiao(Gansu Maternal and Child Health Hospital Clinical Laboratory Center,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院临床检验中心,兰州730050

出　　处：《血栓与止血学》2022年第5期1152-1157,共6页Chinese Journal of Thrombosis and Hemostasis

基　　金：甘肃省自然科学基金(18JR3RA037)。

摘　　要：目的评估反复流产病例中抗磷脂综合征(Antiphospholipid syndrome,APS)的患病率,以及各抗体占比分析。方法对诊断明确、资料完整的1914例复发性流产患者进行狼疮抗凝物(LA)、抗心磷脂抗体(ACA)及抗β2糖蛋白1(β2-GP1)抗体的回顾性分析。结果诊断出APS的病例共623例,阳性率32.55%,其中LA阳性患者467例占24.4%;ACA-IgG患者25例占1.3%;ACA-IgM患者50例占2.6%;抗β2-GP1抗体患者185例占9.7%。其中,LA合并ACA-IgG阳性7例占0.37%;LA合并ACA-IgM阳性16例占0.84%;LA合并抗β2-GP1抗体阳性64例占3.34%;ACA合并抗β2-GP1抗体阳性15例占0.78%;LA、ACA和抗β2-GP1抗体阳性1例占0.052%。通过分析年龄与ACA、LA及抗β2-GP1抗体相关性,发现LA及ACA-IgM与年龄具有一定的相关性(P<0.05);而ACA-IgG及抗β2-GP1抗体与年龄无相关性(P<0.05)。结论由APS导致的复发性流产占32.55%,三种磷脂抗体中LA阳性率最高,其次为抗β2-GPI抗体及ACA;LA与妊娠年龄相关性大于抗β2-GP1抗体及ACA,在育龄女性中发病率更高,建议对复发性流产患者应进行全面的抗磷脂抗体检测。Objective To evaluate the prevalence of Antiphospholipid syndrome(APS)in recurrent abortion cases,and to analyze the proportion of positivity of each antibody.Methods A retrospective analysis of lupus anticoagulant(LA),anticardiolipin antibody(ACA)and anti-β2glycoprotein 1(β2-GP1)antibody was performed in 1914 patients diagnosed with recurrent abortion who had complete clinical data.Results A total of 623 cases were diagnosed with APS,and the positive rate was 32.55%.Among them,467 cases of LA positive accounted for 24.4%;25 cases of ACA-IgG positive accounted for 1.3%;50 cases of ACA-IgM positive accounted for 2.6%;185 cases ofβ2-GP1 positive accounted for 9.7%.In addition,7 cases of LA combined with ACA-IgG positive accounted for 0.37%;16cases of LA combined with ACA-IgM positive accounted for 0.84%;64 cases of LA combined with anti-β2-GP1 antibody positive accounted for 3.34%;15 cases of ACA combined with anti-β2-GP1 antibody positive accounted for 0.78%;1 case of LA,ACA and anti-β2-positive accounted for 0.05%.By analyzing the correlation between age and ACA,LA and anti-β2-GP1 antibody,it was found that LA and ACA(IgM)have a certain correlation with age(P<0.05);while ACA(IgG)and anti-β2-GP1 antibody had no correlation with age(P>0.05).Conclusions Recurrent abortion caused by APS accounted for 32.55%.Among the three phospholipid antibodies,LA had the highest positive rate,followed by anti-β2-GP1antibody and ACA.The correlation between LA and gestational age was greater than that of anti-β2-GP1antibody and ACA.The incidence is higher,and comprehensive antiphospholipid antibody testing is recommended in patients with recurrent abortion.

关 键 词：复发性流产 抗磷脂综合征 狼疮抗凝物 抗心磷脂抗体 抗β2-糖蛋白1抗体 

分 类 号：R714.21[医药卫生—妇产科学]