Regan L, Braude P R, Hill D P
Department of Obstetrics and Gynaecology, University of Cambridge, UK.
Hum Reprod. 1991 Feb;6(2):294-8. doi: 10.1093/oxfordjournals.humrep.a137325.
The incidence and natural history of serum anti-paternal cytotoxic antibody (APCA) in normal pregnancy and spontaneous abortion was investigated prospectively in 306 women (64 primigravidae and 242 multigravidae), in order to establish whether serum APCA is a useful screening test in the diagnosis, treatment and prognosis for patients with recurrent pregnancy loss. Pre-pregnancy, serial pregnancy and post delivery serum samples were tested against partner's lymphocytes, using a microdroplet lymphocytotoxicity assay. The incidence of serum APCA in the 256 pregnancies successfully completed was 32%, compared with 10% amongst the 50 pregnancies ending in spontaneous abortion. The lower incidence of positive APCA tests in unsuccessful pregnancies was explained by our finding that positive APCA tests are related to the gestational age of the pregnancy and are rarely demonstrable before 28 weeks gestation. Since APCA usually disappears between pregnancies, its usefulness as a diagnostic test for immunotherapy against recurrent abortion should be questioned.
为确定血清抗父本细胞毒性抗体（APCA）在复发性流产患者的诊断、治疗及预后方面是否为一项有用的筛查试验，我们对306名女性（64名初产妇和242名经产妇）进行了前瞻性研究，观察正常妊娠和自然流产中血清APCA的发生率及自然病程。孕前、孕期系列检查及产后的血清样本采用微量淋巴细胞毒性试验检测其与伴侣淋巴细胞的反应。在成功完成的256次妊娠中，血清APCA的发生率为32%，而在以自然流产告终的50次妊娠中，这一发生率为10%。我们发现APCA阳性试验与妊娠孕周有关，在妊娠28周前很少能检测到，这就解释了在妊娠失败中APCA阳性试验发生率较低的原因。由于APCA通常在妊娠之间消失，因此其作为复发性流产免疫治疗诊断试验的实用性值得质疑。
