【摘要】 目的探究狼疮抗凝物、抗β2糖蛋白1抗体及抗心磷脂抗体对妊娠不良事件的影响。方法收集2017年1月至2019年6月发生妊娠不良事件妊娠者72例为观察组,另选同期未发生妊娠不良事件的妊娠者214例为正常组。统计分析观察组中72例妊娠者中所发生的妊娠不良事件及所占的人数;应用ELISA方法和部分凝血酶原时间法联合检测2组妊娠患者体内狼疮抗凝物、抗心磷脂抗体和抗β2糖蛋白Ⅰ抗体的表达;通过Werfen ACL-TOP700全自动血凝分析仪及发色底物法测定2组妊娠者D-二聚体的表达水平;同时对观察组中妊娠者D-二聚体与狼疮抗凝物、抗β2糖蛋白1抗体和抗心磷脂抗体进行相关性分析。结果观察组的72例妊娠者包括:习惯性流产(n=24)、早产(n=38)、死胎(n=10);观察组中狼疮抗凝物、抗β2糖蛋白1抗体、抗心磷脂抗体的阳性百分比均高于正常组,差异有统计学意义(P<0.05);观察组2个或2个以上抗磷脂抗体(狼疮抗凝物、抗β2糖蛋白1抗体及抗心磷脂抗体)联合阳性的百分比均明显高于正常组,差异有统计学意义(P<0.05);观察组中D-二聚体的表达水平明显高于正常组的表达,差异有统计学意义(P<0.05);进一步分析发现观察组中D-二聚体与狼疮抗凝物、抗β2糖蛋白1抗体和抗心磷脂抗体之间存在着正相关性,差异有统计学意义(P<0.05)。结论狼疮抗凝物、抗β2糖蛋白1抗体及抗心磷脂抗体与妊娠不良事件有关,并且可能通过作用于D-二聚体进而影响妊娠不良事件的发生,对于易发生妊娠不良事件妊娠者,应常规、全面的筛查抗磷脂抗体,以期对其早期干预,进而降低妊娠不良事件的发生率,提高妊娠率。更多还原

【Abstract】 Objective To investigate the effects of positive lupus anticoagulant, antiserum β2 glycoprotein1 antibody and anticardiolipin antibody(IgG/M) on adverse pregnancy events.Methods The clinical data about 286 patients who were admitted and treated in our hospital from January 2014 to December 2016 were retrospective analyzed,who were divied into adverse gestation event group(n=72) and control group without the incidence of adverse pregnancy events(n=214). The expression levels of anti phospholipid antibodies(lupus anticoagulant, anti β2 glycoprotein1 antibody and anti cardiolipin antibody IgG/M) and the probability of adverse pregnancy reaction were further analyzed. At the same time, the clinical data of 96 pregnancy patients with abnormal antiphospholipid antibody who were treated in our hospital from January 2017 to June 2019 were collected,who were divided into single positive group(anti cardiolipin antibody IgG/M), double positive group(anti cardiolipin antibody IgG/M positive+anti β2 glycoprotein1 antibody) and triple positive group(lupus anticoagulation positive+ anti β2 glycoprotein1 antibodies positive+anti cardiolipin antibody IgG/M), with 32 cases in each group. The expression levels of lupus anticoagulation, anti cardiolipin antibody IgG/M and antiβ2 glycoprotein1 antibody were detected by ELISA method, and then the pregnancy adverse events were observed and compared among the three groups.Results The retrospective analysis showed that the cases with adverse events in triple positive group were the highest, followed by the double positive group,finally the single positive group(P<0.05). Moreover the propotion of cases with habitual abortion, premature delivery, stillbirth and gestational hypertension was the highest in triple positive group, followed by double positive group,finally the single positive group(P<0.05). In addition the D dimer levels were the highest in triple positive group, followed by double positive group and single positive group(P<0.05).Conclusion The triple positive antiphospholipid antibodies(lupus anticoagulant+anti β2 glycoprotein1 antibody+ anti cardiolipin antibody IgG/M) can further reflect the incidence of adverse events in pregnant patients, which may become a predictor of the incidence of pregnant adverse events in clinical practice in future.更多还原