Out H J, Bruinse H W, Christiaens G C, van Vliet M, Meilof J F, de Groot P G, Smeenk R J, Derksen R H
Department of Internal Medicine, Division of Immunopathology, University Hospital, Utrecht, The Netherlands.
Ann Rheum Dis. 1991 Aug;50(8):553-7. doi: 10.1136/ard.50.8.553.
The prevalence of antiphospholipid and antinuclear antibodies in 102 patients with at least three unexplained miscarriages before a gestational age of 12 weeks, or at least one intrauterine fetal death after 12 weeks, was investigated and compared with the prevalence in 102 normal pregnant controls. Six patients had a history of thrombosis and six had 'lupus-like' disease. Twenty one patients had anticardiolipin antibodies compared with 10 controls. Serum samples of nine patients and one control contained antinuclear antibodies. The lupus anticoagulant was present in the plasma of five patients with anticardiolipin antibodies. The influence of patient selection on the results was illustrated by the finding that antiphospholipid antibodies and antinuclear antibodies were mainly detected in patients with lupus-like disease or a history of thrombosis. When these patients were excluded there was no significant difference in the prevalence of anticardiolipin and antinuclear antibodies between patients and controls. Therefore, in the absence of lupus-like disease or a history of thrombosis, screening for antiphospholipid antibodies in patients with adverse pregnancy outcomes seems not to be indicated.
对102例在孕12周前至少有三次不明原因流产或12周后至少有一次宫内胎儿死亡的患者，研究其抗磷脂抗体和抗核抗体的患病率，并与102例正常妊娠对照组的患病率进行比较。6例患者有血栓形成史，6例有“狼疮样”疾病史。21例患者有抗心磷脂抗体，而对照组有10例。9例患者和1例对照的血清样本含有抗核抗体。5例有抗心磷脂抗体的患者血浆中存在狼疮抗凝物。抗磷脂抗体和抗核抗体主要在有狼疮样疾病或血栓形成史的患者中检测到，这一发现说明了患者选择对结果的影响。当排除这些患者后，患者与对照组之间抗心磷脂抗体和抗核抗体的患病率无显著差异。因此，在没有狼疮样疾病或血栓形成史的情况下，对妊娠结局不良的患者进行抗磷脂抗体筛查似乎并无必要。
