抗精子抗体、抗子宫内膜抗体、抗心磷脂抗体和抗核抗体检测在复发性流产诊断中的价值

目的探讨抗精子抗体(antisperm antibody,AsAb)、抗子宫内膜抗体(anti-endometrial antibody,EmAb)、抗心磷脂抗体(anticardiolipin antibody,ACA)及抗核抗体(antinuclear antibody,ANA)的检测在复发性流产(recurrent spontaneous abortion,RSA)诊断中的价值。方法选取2016年8月至2019年4月在成都市妇女儿童中心医院就诊并诊断为RSA的患者473例为研究组,选取同期无任何不良孕产史的已生育健康女性152例为对照组。对两组对象用酶联免疫吸附法测定AsAb、EmAb、ACA,用免疫印迹法测定ANA。结果研究组和对照组AsAb、EmAb、ACA和ANA检出阳性率分别为20.08%、15.22%、23.04%、20.71%和3.95%、1.97%、5.26%、4.61%,两组比较差异有统计学意义(P<0.05);研究组和对照组ANA谱中抗双链DNA抗体(double stranded DNA antibody,dsDNA)、抗Ro-52抗体阳性率分别为5.50%、4.23%和1.32%、0,两组比较差异有统计学意义(P<0.05);不同流产次数患者AsAb、EmAb、ACA及ANA阳性率比较,差异无统计学意义(P>0.05);研究组和对照组AsAb、EmAb、ACA及ANA联合检测阳性率分别为71.46%和15.79%,两组比较差异有统计学意义(P<0.05);研究组单一AsAb、EmAb、ACA及ANA检测阳性率与4种抗体联合检测阳性率比较,差异有统计学意义(P<0.05)。结论AsAb、EmAb、ACA及ANA与RSA具有相关性;AsAb、EmAb、ACA与ANA联合检测诊断RSA的价值优于单独检测。

The value of anti-sperm,anti-uterine,anti-cardiolipin and anti-nuclear antibody assays in the diagnosis of recurrent spontaneous abortion

Objective Explore the value of detection of anti-sperm antibody(AsAb),antiendometrial antibody(anti-Emab),anti-cardiolipin antibody(ACA)and anti-nuclear antibody(ANA)in the diagnosis of recurrent spontaneous abortion(RSA).Methods 473 cases of patients with RSA diagnosed at Chengdu Women's and Children's Center Hospital from August 2016 to April 2019 were selected as the study group,and 152 cases of reproductively healthy women without any history of adverse pregnancy and childbirth during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to determine AsAb,EmAb and ACA,and immunoblot was used to determine ANA.Results The positive rates of AsAb,EmAb,ACA and ANA in the study group and the control group were 20.08%,15.22%,23.04%,20.71%and 3.95%,1.97%,5.26%and 4.61%,respectively.There were significant differences between the two groups(P<0.05).The positive rates of anti-dsDNA antibody and anti-Ro-52 antibody in ANA spectrum of the study group and the control group were 5.50%,4.23%and 1.32%,0 respectively.There were significant differences between the two groups(P<0.05).There were no significant differences in the positive rates of AsAb,EmAb,ACA and ANA spectrum among the patients with different times of abortion(P>0.05).The positive rates of AsAb,EmAb,ACA and ANA in the study group and the control group were 71.46%and 15.79%,respectively.There were significant differences between the two groups(P<0.05).The positive rate of single AsAb,EMAb,ACA and ANA in the study group was significantly higher than that of combined detection of four antibodies(P<0.05).Conclusion AsAb,EmAb,ACA and ANA were correlated with RSA.The combined determination of AsAb,EmAb,ACA and ANA is better than single determination in the diagnosis of RSA.