孕妇抗核抗体谱与胎儿发育异常的关系  

Relationship between anti-nuclear antibody spectrum in pregnant women and fetal developmental abnormalities

作　　者：杜红梅[1,2] 王全先 刘丽莎[1,2] 马玲 牛超[1,2] 袁恩武 DU Hongmei;WANG Quanxian;LIU Lisha;MA Ling;NIU Chao;YUAN Enwu(Department of Clinical Laboratory,the Third Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Zhengzhou Key Laboratory for In Vitro Diagnosis of Hypertensive Disorders of Pregnancy,Zhengzhou 450052)

机构地区：[1]郑州大学第三附属医院检验医学科,郑州450052 [2]郑州市妊娠高血压疾病体外诊断重点实验室,郑州450052

出　　处：《郑州大学学报（医学版）》2024年第3期420-423,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省医学科技攻关计划项目(SBGJ202302081)。

摘　　要：目的:探讨孕妇抗核抗体谱与胎儿发育异常的关系。方法:选择2020年1月至2023年12月在郑州大学第三附属医院行抗核抗体谱检测的孕妇2490例,通过胎儿四维彩超和超声心动图检测胎儿发育情况。使用免疫印迹法检测孕妇血清抗核抗体谱(抗双链DNA、核小体、组蛋白、核糖体蛋白P、SM、nRNP、SSA/Ro60、SSA/Ro52、SSB/La、着丝点、Scl-70和Jo-1抗体)。比较胎儿发育正常和发育异常孕妇血清抗核抗体谱阳性检出情况,胎儿心脏发育正常和发育异常孕妇血清抗着丝点抗体、抗SSA/Ro52抗体、抗着丝点或SSA/Ro52抗体和抗SSA/Ro60+SSA/Ro52+SSB/La抗体阳性检出情况。分析抗核抗体谱在胎儿心脏异常中的诊断价值。结果:2490例孕妇抗核抗体谱阳性检出率为5.38%。胎儿发育异常孕妇抗核抗体谱阳性检出率为7.2%(37/514),高于胎儿发育正常孕妇的4.9%(97/1976)(P=0.040)。胎儿发育正常和发育异常孕妇抗SSA/Ro60、SSA/Ro52、SSB/La和着丝点抗体阳性检出率比较,差异无统计学意义(P>0.05);78例胎儿心脏异常,其中心血管畸形51例、心律失常27例。胎儿心脏发育正常和发育异常孕妇抗着丝点抗体、抗SSA/Ro52抗体、抗着丝点或SSA/Ro52抗体、抗SSA/Ro60+SSA/Ro52+SSB/La抗体阳性检出率比较,差异有统计学意义(P<0.05)。孕妇抗着丝点或SSA/Ro52抗体预测胎儿心脏发育异常的敏感度和阴性预测值分别为0.090和0.971;抗着丝点抗体预测的特异度和阳性预测值分别为0.999和0.400。结论:孕妇血清抗着丝点抗体、抗SSA/Ro52抗体以及抗SSA/Ro60+SSA/Ro52+SSB/La抗体阳性,可能提示胎儿心脏发育异常。Aim:To explore the relationship between anti-nuclear antibody spectrum in pregnant women and fetal developmental abnormalities.Methods:A total of 2490 pregnant women who underwent anti-nuclear antibody spectrum examination at the Third Affiliated Hospital of Zhengzhou University from January 2020 to December 2023 were selected,and fetal development was dectected through fetal four-dimensional ultrasound and fetal echocardiography.Immunoblotting method was used to detect the serum anti-nuclear antibody spectrum of pregnant women(anti-double stranded DNA antibody,anti-nucleosome antibody,anti-histone antibody,anti-ribosomal protein P antibody,anti-SM antibody,anti-nRNP antibody,anti-SSA/Ro60 antibody,anti-SSA/Ro52 antibody,anti-SSB/La antibody,anti-centromere antibody,anti-Scl-70 antibody,and anti-Jo-1 antibody).The positive detection rate of serum anti-nuclear antibody spectrum between pregnant women with abnormal fetal development and those with normal fetal development was compared.The detection of serum anti-centromere antibody,anti-SSA/Ro52 antibody,anti-centromere or anti-SSA/Ro52 antibody,and anti-SSA/Ro60+SSA/Ro52+SSB/La antibodies in pregnant women with fetal cardiac abnormal and normal development was performed.The diagnostic value of anti-nuclear antibody spectrum in fetal cardiac abnormalities was analyzed.Results:The total positive detection rate of anti-nuclear antibody spectrum in 2490 pregnant women was 5.38%.The positive rate of anti-nuclear antibody spectrum in pregnant women with abnormal fetal development was 7.2%(37/514),which was higher than that[4.9%(97/1976)]in pregnant women with normal fetal development(P=0.040).There were no significant differences in the positive detection rate of anti-SSA/Ro60 antibody,anti-SSA/Ro52 antibody,anti-SSB/La antibody,or anti-centromere antibody between the abnormal fetal development group and the normal fetal development group(P>0.05),78 pregnant women had fetal cardiac development abnormalities,including 51 cases of cardiovascular malformations and 27 cases

关 键 词：抗核抗体谱 抗SSA抗体 抗SSB抗体 胎儿发育异常 心脏发育异常 

分 类 号：R715[医药卫生—妇产科学]