特发性复发性流产妇女中抗蛋白 Z IgM 和 IgG 自身抗体的高频率。

High Frequency of anti-protein Z IgM and IgG autoantibodies in women with idiopathic recurrent spontaneous miscarriage.

机构信息

Department of Medical Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.

出版信息

Am J Reprod Immunol. 2011 May;65(5):526-31. doi: 10.1111/j.1600-0897.2010.00925.x. Epub 2010 Nov 19.

DOI:10.1111/j.1600-0897.2010.00925.x

PMID:21087334

Abstract

PROBLEM

Protein Z (PZ) system is an anticoagulant pathway involved in the physiologic regulation of coagulation, and PZ deficiency reportedly enhances prothrombophilic mechanisms, including those implicated with idiopathic recurrent miscarriage (RSM). We investigate plasma anti-PZ IgM and IgG levels in RSM women and in multiparous control women.

METHODS

Anti-PZ IgM and IgG levels were measured in 265 RSM women and 283 age-matched control women by ELISA.

RESULTS

Elevated anti-PZ IgG (P < 0.001) and IgM (p < 0.001) titers were seen in patients. The areas under the curves for ROC curve for anti-PZ IgM (0.898 ± 0.044) and IgG (0.898 ± 0.042) demonstrated no variation in diagnostic capacity. Multivariate analysis confirmed the association of elevated anti-PZ IgM [adjusted odds ratio, aOR (95% CI) = 6.46 (2.44-17.11)] and IgG [aOR (95% CI) = 7.44 (2.54-21.79)] as independent predictors of RSM after adjusting for confounding covariates and demonstrated a clear gradation of increasing RSM risk associated with increased antibody titers.

CONCLUSION

The presence of anti-PZ IgM and IgG antibodies are risk factors for RSM.

摘要

问题

蛋白 Z（PZ）系统是参与凝血生理调节的抗凝途径，据报道 PZ 缺乏会增强促血栓形成机制，包括与特发性复发性流产（RSM）相关的机制。我们研究了 RSM 女性和多产妇对照女性的血浆抗 PZ IgM 和 IgG 水平。

方法

通过 ELISA 测量了 265 名 RSM 女性和 283 名年龄匹配的对照女性的抗 PZ IgM 和 IgG 水平。

结果

患者中可见抗 PZ IgG（P < 0.001）和 IgM（p < 0.001）滴度升高。ROC 曲线的抗 PZ IgM（0.898 ± 0.044）和 IgG（0.898 ± 0.042）的曲线下面积显示诊断能力无变化。多变量分析证实，在调整混杂协变量后，升高的抗 PZ IgM [调整后的优势比（95%可信区间）= 6.46（2.44-17.11）]和 IgG [调整后的优势比（95%可信区间）= 7.44（2.54-21.79）]与 RSM 独立相关，且抗体滴度升高与 RSM 风险增加呈明显梯度关系。