抗磷脂抗体与自然流产患者既往流产次数的相关性分析  

Correlation between antiphospholipid antibodies and number of previous abortions in patients with spontaneous abortion

作　　者：陈聪 游晓玲 莫李芳 陈现 李龙飞 蔡松辰 曾勇 李玉叶 CHEN Cong;YOU Xiao-ling;MO Li-fang;CHEN Xian;LI Long-fei;CAI Song-chen;ZENG Yong;LI Yu-ye(Laboratory of Reproductive Immunity,Shenzhen Zhongshan Urological Hospital,Guangdong Implantation Reproductive Immunity Engineering Technology Research Center,Shenzhen 518043)

机构地区：[1]深圳中山泌尿外科医院生殖免疫实验室,广东省围着床期生殖免疫工程技术研究中心,深圳518043

出　　处：《生殖医学杂志》2023年第9期1348-1354,共7页Journal of Reproductive Medicine

摘　　要：目的探讨典型和非典型抗磷脂抗体与自然流产患者既往流产次数的相关性。方法选择2019年5月至2022年8月于深圳中山泌尿外科医院就诊的自然流产患者878例,根据患者既往流产次数分为1次流产组(S1组,n=478)、2次流产组(S2组,n=292)、3次流产组(S3组,n=73)及≥4次流产组(S4组,n=35)。采用化学发光法和酶联免疫吸附法(ELISA)分别检测患者未孕状态下血清中典型抗磷脂抗体[抗β2糖蛋白1抗体(aβ2GPI)、抗心磷脂抗体(aCL)]和非典型抗磷脂抗体[抗磷脂酰丝氨酸/凝血酶原复合物抗体(aPS/PT)和抗膜联蛋白A5(aANXA5)]的IgM型和IgG型水平,并比较分析各组间不同类型抗磷脂抗体阳性率的差异。结果非典型抗磷脂抗体aPS/PT(IgM+IgG)和aPS/PT-IgM阳性率在4组间具有显著性差异(P<0.05),且S4组阳性率显著高于其余3组(P<0.05),但S1、S2和S3三组间均无统计学差异(P>0.05)。典型抗磷脂抗体aβ2GPI(IgM+IgG)、aCL(IgM+IgG)、aβ2GPI-IgM、aβ2GPI-IgG、aCL-IgM、aCL-IgG阳性检出率和非典型抗磷脂抗体aANXA5(IgM+IgG)、aANXA5-IgM、aANXA5-IgG及aPS/PT-IgG阳性检出率,在4组患者中的差异均无统计学意义(P>0.05)。结论aβ2GPI、aCL、aANXA5及其分型抗体与既往自然流产次数无显著相关性,但aPS/PT抗体作为非典型的抗磷脂抗体,在≥4次的自然流产次数患者中具有更高的临床检测价值,可作为评估自然流产患者风险的实验室辅助诊断指标。Objective:To investigate the correlation between the typical and atypical antiphospholipid antibodies and the number of previous spontaneous abortion.Methods:A total of 878 patients who experienced spontaneous abortion and visited in Shenzhen Zhongshan Urological Hospital from May 2019 to August 2022 were included in this study.According to the number of previous miscarriages,the patients were divided into four groups:one miscarriage group(S1 group,n=478),two miscarriages group(S2 group,n=292),three miscarriages group(S3 group,n=73)and four or more miscarriages group(S4 group,n=35).The serum IgG/IgM levels of typical antiphospholipid antibodies[anti-β2 glycoprotein 1 antibody(aβ2GPI),anti-cardiolipin antibody(aCL)and atypical antiphospholipid antibodies(anti-phosphatidylserine/prothrombin complex antibody(aPS/PT),anti-annexin V antibodies(aANXA5)in the patients with non-pregnant state were detected by chemiluminescence and enzyme-linked immunosorbent assay(ELISA).The positive rates of different subtypes of antiphospholipid antibodies among the groups were compared.Results:The positive rates of atypical antiphospholipid antibodies aPS/PT(IgM+IgG)and aPS/PT-IgM were significantly different among the four groups(P<0.05),and the positive rate in the S4 group was significantly higher than that in the other three groups(P<0.05).However,there was no significant difference among the S1,S2 and S3 groups(P>0.05).There were no significant differences in the positive rates of typical antiphospholipid antibodies aβ2GPI(IgM+IgG),aCL(IgM+IgG),aβ2GPI-IgM,aβ2GPI-IgM,aCL-IgM,aCL-IgG and atypical antiphospholipid antibodies aANXA5(IgM+IgG),aANXA5-IgM,aANXA5-IgG and the aPS/PT-IgG among the four groups(P>0.05).Conclusions:There was no significant correlation between the aβ2GPI,aCL,aANXA5 and the numbers of previous spontaneous abortion.However,As an atypical antiphospholipid antibody,aPS/PT antibody has higher clinical detection value in patients with≥4 miscarriages,and can be used as a laboratory auxiliary diagnostic indica

关 键 词：自然流产 抗磷脂抗体 抗心磷脂抗体 抗Β2糖蛋白1抗体 抗磷脂酰丝氨酸/凝血酶原复合物抗体 抗膜联蛋白A5抗体 

分 类 号：R711.6[医药卫生—妇产科学]