检测抗心磷脂抗体水平判定先兆流产妊娠结局

目的 探讨血清抗心磷脂抗体(ACA)水平与先兆流产妊娠结局的关系,方法 用酶联免疫吸附法(ECISA)测定212例先兆流产患者的血清抗心磷脂抗体水平并追踪其妊娠结局。结果 212例先兆流产患者中有40例ACA阳性,162例ACA阴性,在40例ACA阳性患者中有21例妊娠结局为稽留流产,发生率为52.5％,而162例ACA阴性患者中有13例妊娠结局为稽留流产,发生率为8.02％,两组比较有显著性差异(P<0.05);且ACA阳性组中妊高征发生率明显高于ACA阴性组。结论 检测先兆流产患者血清ACA水平有助于判定妊娠结局。     

习惯性流产妇女与自身抗体之间关系的探讨

目的了解抗心磷脂抗体、抗人绒毛膜促性腺激素抗体、抗滋养细胞膜抗原抗体与习惯性流产患者之间的关系.方法用ELISA法试剂盒.测定习惯性流产妇女血清中的抗心磷脂抗体、抗绒毛膜抗促性腺激素抗体、抗滋养细胞膜抗原抗体的结果.结果与对照组比较抗心磷脂抗体阳性率为24.41%,有极显著性差异(P＜0.01);抗人绒毛膜促性腺激素抗体其阳性率为29.06%,有极显著性差异(P＜0.01);抗滋养细胞膜抗原抗体阳性率为24.41%有极显著性差异(P＜0.01).结论抗心磷脂抗体、抗人绒毛膜促性腺激素抗体、抗滋养细胞膜抗原抗体与习惯性流产患者之间有着极为密切的关系.     

改良酶联免疫吸附试验检测抗磷脂抗体及其临床意义

应用改良的酶联免疫吸附试验拾测抗磷脂抗体。该法特异性强,经心磷脂抑制试验,其抑制率达67%,经心磷脂吸附纯化后,各类抗心磷脂抗体(ACL)与相应的抗人IgG、IgA、IgM均无反应,沉淀线消失。该法重复性好,三次重复实验附合率达87%。本文对111例系统性红斑狼疮(SLE)患者检测IgG、IgA、IgM三类抗心磷脂抗体及抗磷脂酰丝氨酸、抗磷脂酰肌醇、抗磷脂酰甘油、抗磷脂酸等五种负电性磷脂抗体,分析其阳性率及该抗体与疾病的相关性。本文发现各种抗磷脂抗体(APL)在SLE的阳性率十分接近,33～45%。但各类抗不同磷脂抗体的阳性率差异较大,5～32%。SLE患者的血栓形成与阳性抗磷脂抗体显著相关,分别是IgG-ACL(P=0.002),IgG-APA(P<0.05),IgG-APG(P<0.05)。抗磷脂抗体的升高还与SLE患者的血小板减少,中枢神经系统病变有关(P<0.05);但异常APL与自发性流产的关系尚无统计学意义。本文还发现抗ds-DNA(Farr试验)的升高和阳性直接Coomb′s试验与升高水平的APL显著相关(P<0.05)。抗心磷脂抗体较其他四种负电性磷脂抗体的阳性率高且敏感。因此ACL可作为临床血栓形成的危险标志性检测。     

自然流产的免疫学因素分析与探讨

目的为探讨自然流产与免疫学因素的关系.方法采用酶联免疫吸咐试验（ELISA）对612例自然流产妇女进行血清抗子宫内膜抗体（EMAb）、抗心磷脂抗体（ACA）、抗人绒毛膜促性腺激素抗体（HCGAb）测定.结果流产组132例HCGAb阳性,阳性率为21.5%;150例EMAb阳性,阳性率为24.5%;184例ACA阳性,阳性率为30.1%;63.2%的患者体内有两种以上抗体并存,与对照组比较,有高度显著性差异.结论抗心磷脂抗体、抗人绒毛膜促性腺激素抗体、抗子宫内膜抗体是造成自然流产的不可忽视的免疫学因素.     

妊娠抗磷脂综合征的诊治研究

妊娠抗磷脂综合征为流产和死胎患者的一种自身免疫病。1989年美国围产医学杂志定名。此征为孕妇合并有抗凝血狼疮抗体(lupus anticoagulant)和/或抗心磷脂抗体(anticardiolipin antibody)。此抗体在人体内与血管内皮细胞中的磷脂部份起作用,使血栓素增高,而前列环素产生减少,引起蜕膜中微血管拴塞而流产,或使胎盘中血管发生栓塞而胎死宫内,严重患者可同时合并有其     

反复自然流产的免疫因素分析探讨

为分析探讨反复自然流产的免疫性因素，应用补体微量淋巴细胞毒实验方法检测女性反复自然流产的封闭抗体，用ELISA法检测女性反复自然流产的抗心磷脂抗体(ACA)、抗精子抗体(ASA)共752例。结果显示，封闭抗体与反复自然流产明显相关，抗心磷脂抗体与反复自然流产有一定关系，抗精子抗体与反复自然流产无明显相关。研究表明，封闭抗体、抗心磷脂抗体是造成反复自然流产的重要免疫因素。     

自身抗体与不孕及自发性流产关系的探讨

目的检测抗心磷脂抗体(ACA)和抗精子抗体(AsAb)两种自身抗体在不孕及自发性流产患者中存在的情况,并观察应用阿司匹林治疗ACA阳性反复流产患者的临床效果。方法应用酶联免疫吸附(ELISA)法检测150例原发或继发不孕患者(不孕组)、198例自发性流产或有胚胎停育史患者(流产组)及40例正常对照组血清中的ACA及AsAb抗体。对其中53例ACA阳性反复流产患者在孕前一个月或孕早期采用低剂量阿司匹林治疗。结果不孕组及流产组ACA总阳性率分别为48.00%和50.51%,与对照组(7.50%)相比有非常显著性差异(P<0.001);不孕组及流产组AsAb阳性率分别为31.33%和25.25%,与对照组(10.00%)比较亦有显著性差异(P<0.05)。53例经治疗患者活产婴儿48例,妊娠成功率为90.57%。结论ACA和AsAb等自身抗体是导致不孕及自发性流产的免疫学因素之一,应用低剂量阿司匹林治疗ACA阳性反复流产患者是保证其妊娠成功的有效方法。     

血清抗心磷脂抗体阳性孕妇的临床观察

目的　探讨抗心磷脂抗体 (ACA)阳性的初次妊娠孕妇与不良妊娠的关系。方法　用ELISA法 ,采用结合指数的方法选取ACA阳性初次妊娠孕妇 138例为研究组 ;ACA阴性初次妊娠孕妇 10 0例为对照组 ,2 0周起进行随访观察。结果　在研究组中出现早产 4例 (2 9% )、妊高征 5例 (3 6 % )、流产 18例 (13% )、低出生体重儿 8例 (5 8% )、胎儿宫内发育迟缓(IUGR) 16例 (11 6 % )、死胎 6例 (4 3% )。另外在ACA阳性产妇的新生儿血中有 4例ACA -IgG阳性。对照组中出现流产2例 (2 % )。研究组与对照组比较有极显著性差异 (P <0 0 0 1)。结论　ACA阳性与不良妊娠有关 ,应对孕妇做ACA的常规检测 ,以利于尽早作出预防和治疗。     

不明原因的反复自发性流产与抗心磷脂抗体关系的探讨

<正>近来有报道,抗心磷脂抗体（ACA）与临床表现为血管栓塞,血小板降低及反复自发性流产（RSA）的抗磷脂抗体综合征密切相关。本文收集一批不明原因的RSA患者血清,检测其ACA水平,现报告如下。     

反复流产与抗心磷脂抗体关系的探讨

目的探讨反复流产、宫内死胎,孕中、晚期孕妇与抗磷脂自身抗体的关系.方法采用ELISA方法对1934例患者进行ACA-IgG、ACA-IgM抗体测定.结果表明有反复流产、宫内死胎史患者血中ACA阳性检出率为30.29%.正常早中晚妊娠妇女阳性率为5.11%,检出阳性者中多为先兆流产、宫内发育迟缓及轻度妊高征.结论ACA阳性与反复流产、宫内死胎、先兆流产、宫内发育迟缓有密切关系.     

Anti-thyroid antibodies and antiphospholipid syndrome: evidence of reduced fecundity and of poor pregnancy outcome in recurrent spontaneous aborters

PROBLEM: To determine the presence of anti-thyroid antibodies in patients with primary antiphospholipid syndrome (APS) [antiphospholipid antibodies (aPL) + recurrent spontaneous abortion (RSA)], compare APS alone with APS and thyroid autoimmunity for fecundity and for pregnancy outcome. METHOD OF STUDY: A total of 203 non-pregnant women affected with primary APS were evaluated for anti-thyroid antibodies; 162 non-pregnant women affected with RSA and thyroid autoimmunity alone served as controls. RESULTS: Anti-thyroid antibodies were found in 27% of APS patients studied. Patients with aPL alone had higher percentages of spontaneous pregnancies (P < 0.0001) and live births (P = 0.0003), when compared with patients positive for anti-thyroid antibodies alone or with aPL. CONCLUSIONS: Thyroid autoimmunity is frequently present in APS recurrent aborters and is often associated with either reduced fecundity or with poor pregnancy outcome. Thyroid antibodies should always be evaluated in women with RSA including those with aPL.     

Antiphospholipid antibodies in relation to sterility/infertility

Of the systemic autoimmune diseases that lead to sterility/infertility, antiphospholipid syndrome (APS) has an outstanding importance; it may be associated with abortion and premature birth which are included in its diagnostic criteria, as well as preeclampsia, pregnancy-induced hypertension, foetal retardation, miscarriage, stillbirth and sterility. Between 2004 and 2009, on the Department of Immunology in the Zala County Hospital, 100 female patients with sterility (st)/infertility (if) (33/67), (mean age: 34.08 years) underwent, in addition to history taking and physical examination, an assessment by immune-serologic tests (ANA, anti-dsDNA, ENA-Profile, anti-TPO, a-sperm, aCL, aPS, aβ2GP1, aANX, and aPT). Positive aCL on two occasions could be demonstrated in 27/100 cases (27%) (st/if: 7/20). Among them 4 cases of primary APS have been diagnosed respectively. In the remaining 17 patients the clinical picture did not fulfil criteria. In addition to the twofold positive aCL, unusual antiphospholipid antibodies including aβ2GP1, aPS or both were present in 1/27, 2/27 and 1/27 patients, as well as aANX and aPT in 3/26 and 1/27 patients respectively. One-time positive aCL occurred in 16/100 women (16%) (st/if: 5/11); among them aPT and aβ2GP1 could be detected in 1/16 patient each. Based on the clinical picture, we raised the possibility of primary APS in 2/16 patients. Among the aCL-negative women, we found the unusual antibodies of APS in 8/57 patients (14%) including positivity of aβ2GP1, aPS, aPT and aANX in 4/57, 4/57, 2/57 and 3/57 patients respectively; taking the clinical criteria of APS into consideration, primary APS could be stated in 2/57 patients of them. The 32 pregnancies developed in the follow-up period upon administration of acetylsalicylic acid (ASA) and maintenance dose low molecular weight heparin (LMWH), together with prednisolone in patients with secondary APS, resulted in 23 deliveries and 5 miscarriages; 4 pregnancies are currently in progress. The results of our investigations highlight the significance of demonstrating latent autoimmune diseases in female patients with sterility/infertility, as barrenness can be terminated by the appropriate treatment of these conditions.     

Impact of Anticardiolipin Antibody on the Outcome of In Vitro Fertilization and Embryo Transfer

Citation Zhong Y‐P, Ying Y, Wu H‐T, Zhou C‐Q, Xu Y‐W, Wang Q, Li J, Sheng X‐T, Li J. Impact of anticardiolipin antibody on the outcome of in vitro fertilization and embryo transfer. Am J Reprod Immunol 2011; 66: 504–509 Problem To investigate the impact of anticardiolipin antibody (ACA) on the outcome of in vitro fertilization and embryo transfer (IVF‐ET). Methods A total of 76 infertile women positive for anticardiolipin antibody (ACA+ group) and 819 controls negative for anticardiolipin antibody (ACA? group) undergoing IVF‐ET in the First Affiliated Hospital, to Sun Yat‐Sen University, were retrospectively analyzed. Women were diagnosed as having pure tubal factor infertility. Results The proportion of patients with a history of spontaneous abortion in the ACA+ group was significantly higher than that in ACA? group (19.7% versus 8.9%). The IVF rate, pregnancy rate and implantation rate in the ACA+ group were markedly lower than those in the ACA? group (75.5% versus 78.9%, 31.3% versus 48.6% and 16.1% versus 28.1%, respectively). Furthermore, the incidence of pregnancy loss in the ACA+ group was higher than that in the ACA? group (32.0% versus 15.1%). Conclusion ACA‐positive patients had significantly decreased IVF rate, pregnancy rate and implantation rate and high risk of abortion. Therefore, ACA positivity predicts poor outcome of IVF‐ET, and pre‐treatment to lower ACA level may be clinically beneficial for patients receiving IVF‐ET.     

不孕及反复自然流产患者血清抗精子抗体分析

目的：探讨不孕及反复自然流产与抗精子抗体（AsAb）的关系。方法：用金标法检测有反复自然流产史患者245例（流产组）、原发或继发不孕患者164例（不孕组）及正常妇女40例（对照组）血清中的AsAb。结果：不孕组AsAb总阳性率52.44%,流产组总阳性率48.57%,与对照组比较差异均有统计学意义（P〈0.05）。结论：AsAb与不孕及反复自然流产有着密切关系。     

攀枝花地区400例不良孕产史遗传咨询者细胞遗传学分析

目的对攀枝花地区400例不良孕产史患者行外周血染色体检查,分析攀枝花地区不良孕产史与患者外周血染色体异常的关系。方法按照便利抽样法选取2016年1月~2018月12月在我院诊治的不良孕产史遗传咨询者400例作为研究对象,抽取患者的外周血进行淋巴细胞培养,行染色体制片,采用常规G显带技术对染色体的核型进行分析。结果 400例不良孕产史患者共检出21例染色体异常核型,检出率为5.25%。其中,56例自然流产1次检出异常核型2例,检出率为0.5%;169例自然流产2次检出异常核型5例,检出率为1.25%;67例自然流产3次及以上检出异常核型8例,检出率为2%;32例生育畸形胎儿史检出异常核型1例,检出率为0.25%;46例男性不育检出异常核型3例,检出率为0.75%;30例女性原发不孕检出异常核型2例,检出率为0.5%。染色体异常核型中,4例相互易位,检出率为1%;1例罗伯逊易位,检出率为0.25%;16例多态改变,检出率为4%。自然流产1次、自然流产2次、自然流产3次及以上三组组间比较,差异有统计学意义(P<0.05)。结论染色体异常核型是导致患者发生不良孕产史的主要因素,因此对有不良孕产史的患者进行染色体核型分析,有利于临床医生对患者的病因进行诊断,为不良孕产进行治疗,减少畸形胎儿的出生率,对观测落实优生优育具有重要临床指导价值。     

抗子宫内膜抗体和抗精子抗体在临床中的价值探讨

目的探讨抗精子抗体和抗子宫内膜抗体在临床上检测原发性不孕和复发性自然流产的价值。方法回顾性分析2018年1月至2018年12月在复旦大学附属妇产科医院诊治的原发性不孕患者及复发性自然流产患者病史,以同期进行常规检查的孕妇作为对照,对比研究对象抗子宫内膜抗体、抗精子抗体的水平,分析抗子宫内膜抗体、抗精子抗体在原发性不孕和复发性自然流产中可能的相关性。结果收集到原发性不孕患者170例及复发性自然流产患者238例病史资料,以同期进行常规检查的孕妇208例作为对照组。原发性不孕患者抗精子抗体检测阳性例数显著高于对照组,但抗子宫内膜抗体并无显著改变;复发性自然流产患者抗子宫内膜抗体检测阳性率显著高于对照组,但抗精子抗体并无明显不同;早孕期流产患者抗精子抗体检测阳性率显著高于对照组;发生复发性自然流产在4次以上的病人,其体内抗子宫内膜抗体和抗精子抗体的水平均显著高于对照组。结论抗子宫内膜抗体和抗精子抗体检测在复发性自然流产和原发性不孕患者中具有相关的临床价值,应加强备孕人群的筛查工作,及早干预。     

Marked variation in antiphospholipid antibodies during pregnancy: relationships to pregnancy outcome.

Variations in blood concentrations of antiphospholipid antibodies (APA) were investigated through the course of pregnancy in women who had a history of recurrent pregnancy loss, and were related to changes in pregnancy outcome. Serial measurements of APA were made in 16 women with antiphospholipid syndrome (APS) and 16 with negative APA tests pre-pregnancy. There was considerable intraindividual variation in test results through pregnancy. There was a significantly higher ratio of dilute Russell's viper venom time and IgG ACA titre in the first trimester compared with results pre-pregnancy in women with APS. Furthermore, transiently positive APA results were noted in the control group during pregnancy and some women with antiphospholipid syndrome tested negative for APA in mid- and late pregnancy. We have demonstrated clinically important variations in the results of tests for APA during pregnancy in women with APS.