摘要
抗磷脂抗体(antiphospholipid antibody,APL)与妊娠不良事件密切相关,可导致反复流产、胎儿生长受限、子痫前期、胎儿死亡和早产等妊娠并发症。有学者认为APL阳性是体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)失败的原因之一。APL阳性患者IVF失败率及妊娠并发症发生率均高于APL阴性者。APL持续阳性或三重阳性者,IVF失败次数增加。目前,对于IVF-ET合并APL阳性患者的抗体检测及预防管理仍未达成共识。有学者建议接受IVF-ET患者均进行APL抗体筛查,对APL阳性患者预防性抗凝治疗或使用小剂量阿司匹林(75~100 mg/d)以预防血栓形成,提高妊娠率和活产率。也有研究认为APL与IVF之间的关系仍缺乏循证医学依据,并不推荐对于IVF-ET患者进行APL筛查及预防性治疗。本文就近年IVF-ET合并APL阳性诊治策略的文献进行综述,以期提高对此类患者的认识。
Antiphospholipid antibody(APL)is associated with the adverse events of pregnancy closely,such as recurrent abortion,intrauterine growth restriction,preeclampsia,fetal death and premature delivery.Some scholars believe that APL is one of the reasons for the failure of in vitro fertilization and embryo transfer(IVF-ET).The failure rate of IVF and the pregnancy complications in APL-positive patients were higher than those in APLnegative patients.The frequency of IVF failure could be increased in those patients with persistent-or triplepositive APL.Up to now,there is still no consensus on the antibody testing,and prevention and management,in the APL-positive patients undergoing IVF-ET treatment.Some scholars suggest that patients undergoing IVF-ET treatment should be screened for APL,and that APL-positive patients should be treated with prophylactic anticoagulant or low-dose of aspirin(75-100 mg/d)to prevent thrombosis and to improve the clinical outcomes.However,some studies showed that the relationship between APL and IVF outcomes still lacks the support from the evidence-based medicine,and that APL screening and preventive treatment be not recommended for IVF-ET patients.In this article,we review the research progress on the diagnosis and treatment strategies of APL-positive patients undergoing IVF-ET.
作者
武倩文
马翔
王嫱(审校)
WU Qian-wen;MA Xiang;WANG Qiang(Department of Rheumatology and Immunology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Reproductive Medicine,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《国际生殖健康／计划生育杂志》
CAS
2020年第5期407-410,共4页
Journal of International Reproductive Health/Family Planning
关键词
抗体
抗磷脂
β2糖蛋白Ⅰ
抗磷脂综合征
体外受精
胚胎移植
生殖技术
辅助
Antibodies,antiphospholipid
Beta 2-glycoproteinⅠ
Antiphospholipid syndrome
Fertilization in vitro
Embryo transfer
Reproductive techniques,assisted
