Department of Obstetrics and Gynecology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
J Reprod Immunol. 2010 Jun;85(2):186-92. doi: 10.1016/j.jri.2010.03.002. Epub 2010 May 11.
The prevalence of antiphosphatidylethanolamine antibodies (aPEs) is higher in recurrent pregnancy loss patients than that in women with normal pregnancy. We conducted a cohort study to examine the predictive value of aPE for recurrent pregnancy loss and to determine its clinical significance. We examined plasma protein dependent (P+) and independent (P-) aPE IgG and IgM antibodies in 367 women with two or more unexplained consecutive pregnancy losses. We also examined conventional antiphospholipid antibodies (aPL) such as beta2-glycoprotein I-dependent anticardiolipin antibodies (beta2GPI-dependent aCL), lupus anticoagulant with reference to the dilute activated partial thromboplastin time (aPTT) and the diluted Russell's viper venom time (RVVT). Subsequent pregnancy outcome without medication was examined, and patients with and without aPE were compared. Totals of 37 (10.1%), 14 (3.8%), 23 (6.3%), 6 (1.6%), 9 (2.5%), 10 (2.7%) and 50 (13.6%) of the 367 patients were, respectively, positive for P+aPE IgG, P-aPE IgG, P+aPE IgM, P-aPE IgM, beta2GPI-dependent aCL, lupus anticoagulant by RVVT and LA by aPTT. The patients with aPE differed from patients with beta2GPI-dependent aCL or lupus anticoagulant by RVVT. No difference in live birth rate was apparent between positive and negative aPE patients with no medication. The areas under the curves for each ROC curve for the four aPEs were 0.535, 0.612, 0.546 and 0.533, respectively, so there was no significant variation in diagnostic capacity. We did not obtain any evidence that aPE elevation is an independent risk factor to predict further miscarriage in recurrent pregnancy loss patients.
抗磷脂酰乙醇胺抗体(aPE)在复发性流产患者中的阳性率高于正常妊娠妇女。我们进行了一项队列研究,以检查 aPE 对复发性流产的预测价值,并确定其临床意义。我们检查了 367 名有两次或两次以上不明原因连续妊娠丢失的妇女的血浆蛋白依赖性(P+)和独立(P-)aPE IgG 和 IgM 抗体。我们还检查了常规抗磷脂抗体(aPL),如β2-糖蛋白 I 依赖性抗心磷脂抗体(β2GPI-依赖性 aCL)、狼疮抗凝物与稀释的活化部分凝血活酶时间(aPTT)和稀释的 Russell 蝰蛇毒时间(RVVT)有关。未用药的后续妊娠结局也进行了检查,并比较了有和无 aPE 的患者。367 例患者中,分别有 37 例(10.1%)、14 例(3.8%)、23 例(6.3%)、6 例(1.6%)、9 例(2.5%)、10 例(2.7%)和 50 例(13.6%)对 P+aPE IgG、P-aPE IgG、P+aPE IgM、P-aPE IgM、β2GPI-依赖性 aCL、RVVT 狼疮抗凝物和 aPTT 狼疮抗凝物呈阳性。与β2GPI-依赖性 aCL 或 RVVT 狼疮抗凝物阳性的患者相比,aPE 阳性患者有所不同。无药物治疗的 aPE 阳性和阴性患者的活产率无明显差异。四条 aPE 的 ROC 曲线的曲线下面积分别为 0.535、0.612、0.546 和 0.533,因此诊断能力没有显著差异。我们没有得到任何证据表明 aPE 升高是预测复发性流产患者进一步流产的独立危险因素。