Lee Richard M, Brown Melissa A, Branch D Ware, Ward Kenneth, Silver Robert M
Phoenix Perinatal Associates, Obstetrix Medical Group, Phoenix, Arizona, USA.
Obstet Gynecol. 2003 Aug;102(2):294-300. doi: 10.1016/s0029-7844(03)00477-0.
To estimate whether antiphospholipid antibodies, specifically anticardiolipin and anti-beta(2)-glycoprotein-I antibodies, are associated with preeclampsia.
Plasma was prospectively obtained from four groups of pregnant women: those with 1) mild preeclampsia (n = 109); 2) severe preeclampsia (n = 134); 3) hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome (n = 57); and 4) normotensive controls (n = 100). Anticardiolipin and anti-beta(2)-glycoprotein-I levels were determined by enzyme-linked immunoassay.
Subjects with mild preeclampsia, severe preeclampsia, and HELLP syndrome did not have significantly elevated levels of immunoglobulin G (IgG) and IgM anticardiolipin and anti-beta(2)-glycoprotein-I antibodies compared with normotensive controls (P >.05, Kruskal-Wallis). Similarly, subjects with mild preeclampsia, severe preeclampsia, and HELLP syndrome did not have a significantly higher proportion of women testing positive for each autoantibody compared with normotensive controls (chi(2)). The proportion of patients testing positive for anticardiolipin and anti-beta(2)-glycoprotein-I antibodies were similar in patients with preeclampsia developing before and after 34 weeks' gestation (chi(2)).
Circulating levels of both anticardiolipin and anti-beta(2)-glycoprotein-I antibodies were not increased in patients with mild preeclampsia, severe preeclampsia, or HELLP syndrome compared with normotensive controls. Our data do not support routine testing for anticardiolipin and anti-beta(2)-glycoprotein-I antibodies in women with preeclampsia.
评估抗磷脂抗体,尤其是抗心磷脂抗体和抗β2糖蛋白I抗体,是否与子痫前期相关。
前瞻性地从四组孕妇中获取血浆:1)轻度子痫前期患者(n = 109);2)重度子痫前期患者(n = 134);3)溶血、肝酶升高及血小板减少(HELLP)综合征患者(n = 57);4)血压正常的对照组(n = 100)。采用酶联免疫吸附测定法测定抗心磷脂抗体和抗β2糖蛋白I水平。
与血压正常的对照组相比,轻度子痫前期、重度子痫前期及HELLP综合征患者的免疫球蛋白G(IgG)和IgM抗心磷脂抗体及抗β2糖蛋白I抗体水平未显著升高(P >.05,Kruskal-Wallis检验)。同样,与血压正常的对照组相比,轻度子痫前期、重度子痫前期及HELLP综合征患者中每种自身抗体检测呈阳性的女性比例也未显著更高(卡方检验)。子痫前期发生在妊娠34周之前和之后的患者中,抗心磷脂抗体和抗β2糖蛋白I抗体检测呈阳性的患者比例相似(卡方检验)。
与血压正常的对照组相比,轻度子痫前期、重度子痫前期或HELLP综合征患者的抗心磷脂抗体和抗β2糖蛋白I抗体的循环水平均未升高。我们的数据不支持对子痫前期女性常规检测抗心磷脂抗体和抗β2糖蛋白I抗体。