抗干燥综合征抗原A和抗干燥综合征抗原B抗体对胎儿心脏的影响及诊断治疗  

Effect of materal anti-Sjögren's syndrome type A/Sjögren's syndrome type B antibodies on fetal heart development and the management

作　　者：张梦莹[1] 翟立红[1] 孙笑[1] Zhang Mengying;Zhai Lihong;Sun Xiao(Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院妇产科,北京100034

出　　处：《中华围产医学杂志》2022年第12期987-990,共4页Chinese Journal of Perinatal Medicine

摘　　要：抗Ro/干燥综合征抗原A(Sjögren's syndrome type A,SSA)抗体和抗La/干燥综合征抗原B(Sjögren's syndrome type B,SSB)抗体都属于抗核抗体谱,常见于系统性红斑狼疮、干燥综合征、未分化结缔组织病及无症状患者,约1%的孕妇抗SSA、SSB抗体呈阳性,而抗体阳性的初产孕妇仅有1%~3%的胎儿出现免疫介导的心脏传导阻滞和结构异常。由于其发生率低,起病隐匿,部分孕妇由于孕期胎儿心脏传导阻滞或结构异常而首次诊断抗SSA、SSB抗体阳性。本文针对抗SSA、SSB抗体对胎儿心脏影响的分类、产前的监测与诊断、宫内治疗和预后等方面的国内外研究进行阐述,以指导产科临床工作。Anti-Sjögren's syndrome type A(SSA)and anti-Sjögren's syndrome type B(SSB)antibodies both belong to the antinuclear antibody spectrum and are common in patients with systemic lupus erythematosus,Sjögren's syndrome and undifferentiated connective tissue disease as well as asymptomatic patients.Approximately 1%of pregnant women are positive for anti-SSA and anti-SSB antibodies and only 1%-3%of the fetuses carried by primiparae with anti-SSA and anti-SSB antibodies show immune-mediated cardiac conduction and structural abnormalities.Due to its low incidence and insidious onset,some pregnant women were diagnosed positive for antibodies against SSA and SSB for the first time only due to fetal heart block or structural abnormalities during pregnancy.Domestic and international research on the effects of anti-SSA and anti-SSB antibodies on fetal heart and the prenatal monitoring,diagnosis,intrauterine treatment and prognosis of fetal cardiac abnormalities related to anti-SSA and anti-SSB exposure are reviewed to guide the clinical work of obstetrics.

关 键 词：抗体 抗核 自身抗原 核糖核蛋白类 胎儿心脏 心脏传导阻滞 心脏病 产前诊断 胎儿期疗法 

分 类 号：R714.5[医药卫生—妇产科学]