狼疮抗凝物、抗心磷脂抗体、β2糖蛋白抗体联合检测对妊娠期高血压不良妊娠结局的预测价值  

Combined Detection of Lupus Anticoagulant,Anticardiolipin Antibody and 2-Glycoprotein Antibody in Evaluating the Condition of Gestational Hypertension and Predicting Pregnancy Outcomes

作　　者：张莉梅 李林娜 王欢 王敏 ZHANG Limei;LI Linna;WANG Huan;WANG Min(Department of Obstetrics,Shenzhen Yantian District People′s Hospital,Shenzhen,Guangdong 518000,China)

机构地区：[1]深圳市盐田区人民医院产科,广东深圳518000

出　　处：《岭南心血管病杂志》2025年第1期69-73,83,共6页South China Journal of Cardiovascular Diseases

摘　　要：目的探究狼疮抗凝物(lupus anticoagulant,LA)、抗心磷脂抗体(anticardiolipina antibodies,ACA)、β2糖蛋白抗体(aβ2 glycoprotein 1 antibody,aβ2-GPIs)联合检测对妊娠期高血压(hypertensive disorders of pregnancy,HDP)不良妊娠结局的预测价值。方法选取2021年5月至2023年12月来深圳市盐田区人民医院治疗的121例确诊的HDP患者为研究对象,根据病情严重程度分为轻度组(39例)、中度组(45例)和重度组(37例),根据妊娠结局分为不良妊娠结局组(52例)和良好妊娠结局组(69例);另选取121名同期在本院体检正常妊娠者作为对照组。比较各组研究对象血清LA、ACA、aβ2-GPIs浓度。采用多因素Logistic回归分析对影响因素进行分析。采用四格表法分析LA、ACA、aβ2-GPIs联合对HDP患者不良妊娠结局的预测价值。结果观察组患者LA、ACA、aβ2-GPIs阳性百分比与对照组相比显著升高,差异有统计学意义(χ^(2)=20.275、16.562、11.668,P<0.05);轻度组、中度组和重度组患者血清LA、ACA、aβ2-GPIs阳性百分比呈逐渐升高的趋势,且组间两两比较差异有统计学意义(χ^(2)=25.397、18.183、22.938,P<0.05);不良妊娠结局组患者LA、ACA、aβ2-GPIs阳性百分比与良好妊娠结局组相比显著升高,差异有统计学意义(χ^(2)=32.887、31.881、29.897,P<0.05)。三项联合预测的准确度为85.12%,明显高于各指标单独预测(准确度:75.21%、75.21%、76.03%,P<0.05);3项联合检测的敏感度(82.69%)显著高于血清LA、ACA、aβ2-GPIs单独诊断(敏感度:46.15%、48.08%、46.15%,P<0.05);3项联合检测的特异度(86.96%)显著低于血清LA、aβ2-GPIs单独诊断(特异度:97.10%、98.55%,P<0.05)。结论HDP患者血清LA、ACA、aβ2-GPIs阳性率升高,血清LA、ACA、aβ2-GPIs阳性率随病情加重逐渐升高,且3者联合预测HDP患者发生不良妊娠结局的效能更高,为临床预测妊娠结局提供了一定帮助。Objectives To explore the predictive value of combined detection of lupus anticoagulant(LA),anticardio⁃lipin antibodies(ACA),andβ2-glycoprotein antibodies(aβ2-GPIs)in the assessment of gestational hypertension and pregnancy outcomes.Methods From May 2021 to December 2023,121 confirmed patients with gestational hypertension treated in Shenzhen Yantian District People′s Hospital were collected as the research subjects,another 121 normal preg⁃nant women who underwent physical examination in our hospital were regarded as control group.The serum concentra⁃tions of LA,ACA and aβ2-GPIs were compared.Multivariate Logistic regression analysis was used to analyze the influ⁃encing factors.Four grid table method was applied to analyze the predictive value of the combination of LA,ACA and aβ2-GPIs for adverse pregnancy outcomes in patients with gestational hypertension.Results The positive percentages of LA,ACA,and aβ2-GPIs in observation group were obviously higher than those in control group(χ^(2)=20.275,16.562,11.668;P<0.05).The positive percentages of LA,ACA and aβ2-GPIs in mild,moderate and severe groups showed a gradually increasing trend,and the differences between any two were statistically significant(χ^(2)=25.397,18.183,22.938;P<0.05).The positive percentages of LA,ACA and aβ2-GPIs in the group with poor pregnancy outcomes were obviously higher than those in the group with good pregnancy outcomes(χ^(2)=32.887,31.881,29.897;P<0.05).The sensitivity of the three combined test was obviously(82.69%)higher than that of serum LA,ACA and aβ2-GPIs for individual diagnosis(sensitivity:46.15%,48.08%,46.15%;P<0.05),while the specificity of the three combined tests was significantly(86.96%)lower than that of serum LA,aβ2-GPIs for individual diagnosis(specificity:97.10%,98.55%;P<0.05).Conclusions The positive rates of serum LA,ACA and aβ2-GPIs in patients with gestational hypertension increase,and gradually increase with the severity of the condition.Moreover,the combined prediction of LA,ACA and aβ2-GPIs

关 键 词：妊娠期高血压 狼疮抗凝物 抗心磷脂抗体 β2糖蛋白抗体 病情评估 妊娠结局 

分 类 号：R544.1[医药卫生—心血管疾病]