抗精子抗体与抗心磷脂抗体在不孕女性患者诊断中的价值

目的探讨抗心磷脂抗体（ACA）和抗精子抗体（AsAb）在女性不孕诊断中的价值。方法选取2012年1～12月湖南省妇幼保健院确诊为不孕症的200例女性患者及健康体检者100例，采用酶联免疫吸附实验（ELISA）检测2组血清抗精子抗体（AsAb）、抗心磷脂抗体（ACA）并比较不孕症组与对照组2项抗体的阳性率。结果血清2项生殖免疫性抗体阳性者79例，阳性率39．5％；不孕患者组AsAb阳性率25．5％（51／200）与健康对照组AsAb阳性率1％（1／100）比较，差异有统计学意义（P=0．000）；不孕患者组AcA阳性率为24％（48／200）与健康对照组AcA阳性率1％（1／100）比较，差异有统计学意义（P=0．000）。AsAb-IgG、AsAb-IgM、AsAb-IgA和ACA-IgM、ACA-IgG阳性率与对照组比较差异均有统计学意义（P〈0．05）；ACA-IgA阳性率与对照组比较差异无统计学意义（P〉0．05）；AsAb-IgM和ACA-IgG在不孕不育组内与其他类型抗体阳性率比较，差异均有统计学意义（P〈0．05）。AsAb、ACA阳性率在不同年龄段间与对照组比较，3组差异均有统计学意义（P〈0．05）。结论AsAb、ACA是引起不孕不育的重要的免疫因素，且AsAb-IgM和ACA-IgG与女性不孕不育的关系更加紧密。这些抗体对不同年龄人群的不孕不育患者均有影响，因此AsAb、ACA的检测对免疫性因素引起不孕不育患者的诊断和治疗具有临床价值。

Clinical value of anti-sperm antibody and anticardiolipin antibody in diagnosis of female infertility

Objective To investigate the detective value of anti-sperm antibody （AsAb） and anti-cardiolipin antibody （ACA） in patients with female infertility. Methods 200 female patients diagnosed with infertility and 100 healthy adults were selected in ma- ternal and child health hospital in Hunan province from January 2012 to December 2012. The enzyme linked immunosorbent assay （ELISA） was used to detect serum AsAb and ACA of the two groups and the antibody-positive rates were compared. Results There were 79 positive cases of these two reproductive immune antibody of serum and the positive rate was 39.5%. The positive rates of AsAb were 25.5% （51/200） in infertility patients group and 1% （1/100） in the control group,and the difference was sig- nificant （P=0. 000）. The positive rates of ACA were 14% （28/200） in infertility patients group and 1% （1/100） in the control group,and the difference was significant （P = 0. 000）. Compared with the control group, the positive rate of AsAb-IgG, AsAb- IgM, AsAb IgA, ACA-IgM and ACA-IgG had significant difference （P〈0.05）. Compared with the control group,the positive rate of ACA-IgA was not significantly different （P〉0.05）. And the positive rate of AsAb-IgM and ACA-IgG in the infertility group compared with other types of antibody, the differences were statistically significant （P〈0.05）. And compared with the control group,the positive rate of AsAb and ACA in different age groups was significantly different （P〈0.05）. Conclusion AsAb and ACA were important immune factors caused infertility. AsAb IgM and ACA-IgG were more closely related to female infertility. These antibodies affect the patients with infertility at different age groups. Detection of these antibodies is of important guiding sig- nificance for diagnosis and treatment of immune infertility patients.