摘要
目的 探讨抗磷脂抗体(APL)各亚型与原发性不孕和复发性自然流产(RSA)的相关性分析及小剂量阿司匹林(LDA)的预防效果。方法 选取2021年6月—2023年6月金华市人民医院收治的100例原发性不孕患者作为不孕组和100例RSA患者作为RSA组;同期选取该院正常孕产妇100例作为对照组。采用直接化学发光法测定抗心磷脂抗体(ACA)、免疫球蛋白(Ig)G型ACA、IgM型ACA、抗β2糖蛋白Ⅰ(β2GPⅠ)抗体、IgG型抗β2GPⅠ抗体及IgM型抗β2GPⅠ抗体水平。选取APL阳性患者30例应用LDA预防为LDA干预组,另选取无意愿干预患者30例为LDA对照组。分析影响女性不孕和RSA的危险因素。结果 RSA组ACA、IgG型ACA、IgM型ACA、抗β2GPⅠ抗体、IgG型抗β2GPⅠ抗体及IgM型抗β2GPⅠ抗体[(16.71±5.34)U/ml、(5.89±1.25)U/ml、(8.28±2.54)U/ml、(19.46±6.14)U/ml、(8.28±1.97)U/ml及(12.53±4.12)U/ml]均高于不孕组和对照组;且不孕组ACA、IgG型ACA、IgM型ACA、抗β2GPⅠ抗体、IgG型抗β2GPⅠ抗体及IgM型抗β2GPⅠ抗体[(13.95±3.86)U/ml、(4.57±1.39)U/ml、(5.68±1.73)U/ml、(17.82±5.36)U/ml、(6.72±1.86)U/ml及(9.98±2.47)U/ml]均高于对照组[(11.46±2.37)U/ml、(2.67±0.56)U/ml、(3.08±0.92)U/ml、(15.26±3.48)U/ml、(4.56±1.37)U/ml及(6.71±1.58)U/ml],差异均有统计学意义(F=42.197、206.407、197.067、17.114、113.577及99.852,均P<0.05)。随访至妊娠24周,LDA干预组成功妊娠率(70.00%)高于LDA对照组(43.33%),差异有统计学意义(χ^(2)=4.345,P<0.05)。多因素logistic回归分析结果显示,ACA、IgG型ACA、IgM型ACA、抗β2GPⅠ抗体、IgG型抗β2GPⅠ抗体及IgM型抗β2GPⅠ抗体水平为原发性不孕和RSA的危险因素(均P<0.05)。结论 APL各亚型与原发性不孕和RSA密切相关,且为影响原发性不孕和RSA的危险因素,经LDA预防治疗可提高患者妊娠成功率,值得临床借鉴。
Objective To investigate the correlation analysis between various subtypes of antiphospholipid antibodies(APL)and pri-mary infertility and recurrent spontaneous abortion(RSA),as well as the preventive effect of low-dose aspirin(LDA).Methods100 patients with primary infertility admitted to Jinhua People's Hospital from June 2021 to June 2023 were selected as the infer-tility group,and 100 patients with RSA were selected as the RSA group.During the same period,100 normal pregnant women from the hospi-tal were selected as the control group.The levels of anti cardiolipin antibodies(ACA),immunoglobulin(Ig)G-type ACA,IgM type ACA,anti-β2 glycoprotein 1(β2CPⅠ)antibodies,IgG type anti-β2CPⅠ antibodies,and IgM type anti-β2CPⅠ antibodies were measured u-sing direct chemiluminescence method.Select 30 APL positive patients who received LDA prevention as the LDA intervention group,and an-other 30 patients who did not intend to intervene as the LDA control group.Analyze the risk factors affecting female infertility and RSA.Results The RSA group had higher levels of ACA,IgG ACA,IgM ACA,anti-β2CPⅠ antibody,IgC anti-β2GP Ⅰ antibody,and IgM anti-β2GPⅠ antibody[(16.71±5.34)U/ml,(5.89±1.25)U/ml,(8.28±2.54)U/ml,(19.46±6.14)U/ml,(8.28±1.97)U/ml,and(12.53±4.12)U/ml]compared to the infertility group and the control group.And the infertility group had higher levels of ACA,IgG ACA,IgM ACA,anti-β2GP Ⅰ antibody,IgG anti-β2GPⅠ antibody,and IgM anti-β2CP Ⅰ antibody[(13.95±3.86)U/ml,(4.57±1.39)U/ml,(5.68±1.73)U/ml,(17.82±5.36)U/ml,(6.72±1.86)U/ml,and(9.98±2.47)U/ml]than the control group[(11.46±2.37)U/ml,(2.67±0.56)U/ml,(3.08±0.92)U/ml,(15.26±3.48)U/ml,(4.56±1.37)U/ml,and(6.71±1.58)U/ml].The differences were statistically significant(F=42.197,206.407,197.067,17.114,113.577,and 99.852,all P<0.05).Follow up until 24 weeks of pregnancy showed that the successful pregnancy rate of the LDA intervention group(70.00%)was higher than that of the LDA control group(43.33%),and the difference was statistically significant(X^(2)=4.345,P<0.05).The results of multiple logistic regression analysis showed that ACA,IgG ACA,IgM ACA,anti-β2 GPⅠantibody,IgG anti-β2 GPⅠantibody,and IgM anti-β2GPⅠantibody levels were all risk factors affecting primary infertility and RSA(P<0.05).ConclusionnThevarioussubtypes of APL are closely related to primary infertility and RSA,and in order to influence the risk factors of primary infertility and RSA,LDA prevention and treatment can improve the success rate of pregnancy in patients,which is worthy of clinical reference.
作者
戚建锋
何健英
叶玉玲
李池慧
翁巍
伊碧霞
QI Jian-feng;HE Jian-ying;YE Yu-ling;LI Chi-hui;WENG Wei;YIN Bi-xia(不详;Department of Clinical laboratory,Jinhua People's Hospital,Jinhua,Zhejiang 321000,China)
出处
《中国妇幼保健》
2025年第14期2618-2622,共5页
Maternal and Child Health Care of China
基金
浙江省金华市科学技术研究计划项目(2020-4-039)。
关键词
抗磷脂抗体各亚型
原发性不孕
复发性自然流产
相关性
干预
妊娠
Various subtypes of antiphospholipid antibodies
Primary infertility
Recurrent spontaneous abortion
Relativity
Interven-tion
Gestation
