多种自身免疫性疾病对早期自然流产的影响  

The inf luence of autoimmune diseases on early spontaneous abortion

作　　者：彭干露 代爽 卢漫 李国胜 周全 陈爱华 PENG Ganlu;DAI Shuang;LU Man;LI Guosheng;ZHOU Quan;CHEN Aihua(First College of Clinical Medical Science,China Three Gorges University,Yichang 443000,China)

机构地区：[1]三峡大学第一临床医学院,宜昌443000

出　　处：《免疫学杂志》2025年第1期44-51,共8页Immunological Journal

基　　金：国家中医药管理局中药药理科研三级实验室开放基金(2023PTCM04)。

摘　　要：目的系统评价自身免疫性疾病(AIDs)对女性早期自然流产(ESA)的影响。方法检索Ovid、Web of Science等多个数据库2000年1月至2024年5月的研究,进行回顾性分析。按AIDs的种类、洲际、是否应用人工辅助生殖手段进行亚组分析。结果经筛选,共有73项研究符合条件,并纳入本次分析;AIDs人群与正常妊娠人群ESA的风险存在统计学差异(OR=1.832,95%CI:1.619-2.073);进行AIDs的亚组研究时,部分AIDs患者的ESA风险的增加具有统计学意义,如甲状腺自身免疫、抗磷脂综合征、系统性红斑狼疮、干燥综合征、抗核抗体阳性和类风湿性关节炎;部分AIDs对ESA产生的影响仍是不确定的,如炎症性肠病、溃疡性结肠炎、克罗恩病、自身免疫性皮肤病及视神经脊髓炎谱系障碍;使用了辅助生殖技术的抗磷脂综合征患者ESA的风险更高;相比于其他洲际,非洲AIDs患者的ESA风险不高。结论多种AIDs与ESA的高风险相关。Objective To systematically evaluate of the effect of autoimmune diseases(AIDs)on early spontaneous abortion(ESA).Methods Several databases such as Ovid and Web of Science were searched from January 2000 to May 2024 for retrospective analysis.Furthermore,subgroup analysis was conducted in terms of AIDs,continent and assisted reproduction.Results Total of 73 eligible studies were included in this study.There was a statistically significant difference in the risk of ESA between the population with AIDs and the population with normal pregnancy(OR=1.832,95%CI:1.619-2.073).When subgroup studies of AIDs were performed,the increased risk of ESA in patients with some AIDs was statistically significant:e.g.,thyroid autoimmunity,antiphospholipid syndrome,systemic lupus erythematosus,desiccation syndrome,antinuclear antibody positivity and rheumatoid arthritis.While the impact of some AIDs on ESA was still uncertain,e.g.inflammatory bowel disease,ulcerative colitis,Crohn's disease,autoimmune skin diseases,neuromyelitis optica spectrum disorders.In addition,patients with antiphospholipid syndrome who had underwent assisted reproductive technologies were at higher risk of ESA.Furthermore,compared to other continents,there is a difference in the risk of ESA in patients with AIDs in Africa.Conclusion AIDs are associated with the risk of ESA.

关 键 词：自身免疫性疾病 早期自然流产 甲状腺自身免疫 系统性红斑狼疮 抗磷脂综合征 

分 类 号：R714.21[医药卫生—妇产科学]