抗β2糖蛋白Ⅰ抗体对抗磷脂综合征患者妊娠丢失及免疫调节治疗疗效影响

摘要

目的 探讨抗β2糖蛋白Ⅰ(β2GP Ⅰ)抗体对抗磷脂综合征患者妊娠丢失及免疫调节治疗疗效的影响.方法 将2006年6月至2009年12月在中南大学湘雅二医院产科住院治疗的抗磷脂综合征确诊患者共191例按不同抗体阳性分为3组:A组154例:抗心磷脂抗体(ACA)(+),β2GP Ⅰ(-)；B组26例:ACA(+),β2GP Ⅰ(+)；C组11例:ACA(-),β2GP Ⅰ(+).分析各组的妊娠丢失率及免疫治疗的疗效.结果 治疗前,A、B、C3组间妊娠丢失率( 61.59％,69.84％,67.86％)差异无统计学意义(P＞0.05).经免疫调节治疗后,B组(46.15％)患者妊娠丢失率明显高于A组(22.08％),差异有统计学意义(P＜0.05)；C组(36.36％)与A组、B组比较差异无统计学意义(P＞0.05).结论 抗β2GP Ⅰ抗体对抗磷脂综合征患者妊娠丢失率的影响与ACA相似；抗β2GPⅠ抗体(+)合并ACA(+)的抗磷脂综合征患者对免疫调节治疗的疗效欠佳.%Objective To study the influences of anti-(32-glycoprotein I antibodies on pregnancy loss and therapy response of patients with APS. Methods 191 patients with APS were divided into 3 groups according to different antibodies detected, group A:ACA(+)B2GPI (-)(n = 154); group B:ACA(+)B2GP I (+)(n=26); group C:ACA(-) B2GP I(+)(n = ll). Analyze the pregnancy rate and therapeutic reaction of the patients. Results The pregnancy loss rate of group A,B and C before therapy were respectively 61. 59% ,69. 84% and 67. 86% .which were equal among the three groups. The pregnancy loss rate of group A, B and C after therapy were respectively 22.08% ,46. 15% , 36. 36% , which was lower in group A than group B (P < 0. 05) , and equal between group A and C, group B and C. Conclusion The influence of anti-β2-glycoprotein I antibodies on pregnancy loss rate was equal to ACA. Patients of APS who had both positive anti-β2-glycoprotein I antibodies and ACA were poorly reactive to immunoregulatory therapy.