Skrzypczak Jana, Rajewski Marcin, Wirstlein Przemysław, Goździewicz Tomasz, Zimmer Mariusz, Wołczyński Sławomir, Leszczyńska-Gorzelak Bozena, Breborowicz Grzegorz, Ludwikowski Grzegorz
Klinika Rozrodczości, Katedry Ginekologii, Połoznictwa i Ginekologii Onkologicznej Uniwersytetu Medycznego w Poznaniu, Polska.
Ginekol Pol. 2011 Oct;82(10):749-54.
The aim of the study was the analysis of antiphospholipid syndrome frequency in Polish women with pregnancy loss.
We analyzed 352 women with average age of 31.4 (+/- 4.3) who experienced one or more pregnancy losses. Patients from 5 University centers: Poznań, Białystok, Lublin, Wrocław and Bydgoszcz were divided into 3 groups. In the 1st group there were 150 women with recurrent early pregnancy losses before 10 weeks gestation, in the 2nd group we included 160 women with late pregnancy losses, in the 3rd group we analyzed 42 women with labor complicated by preeclampsia or placental insufficiency within or before 34 gestational week. All 352 women were screened for the presence of anticardiolipin antibodies (aCL), anti beta2glikoprotein I (abeta2GPI) and lupus anticoagulant (LA). The first two antibodies were investigated with ELISA test and the last one with APPT based test. Only the second positive result qualified patients as antiphospholipid antibody (aPL) positive. Antibodies against cardiolipin and beta2glicoprotein I were analyzed in three classes--IgA, IgG and IgM--where the laboratory criteria of positivity were titers above 40 unitsU/ml or above 99 centile.
13 patients (3.69%) in the screened population of 352 women met the criteria of the antiphospholipid syndrome. The frequency of APS in women with early and late pregnancy losses were 1.33% and 6.25%, respectively. The most common antibody found was lupus anticoagulant (LA). In 3 women with late pregnancy loss all three antibodies were found. In women with premature deliveries complicated with preeclampsia and/or placental insufficiency the frequency of APS was 2.58%.
本研究旨在分析波兰有流产史女性中抗磷脂综合征的发生率。
我们分析了352名平均年龄为31.4(±4.3)岁、有一次或多次流产经历的女性。来自波兹南、比亚韦斯托克、卢布林、弗罗茨瓦夫和比得哥什5所大学中心的患者被分为3组。第一组有150名妊娠10周前有复发性早期流产的女性,第二组纳入160名有晚期流产的女性,第三组分析了42名在妊娠34周内或之前分娩并发子痫前期或胎盘功能不全的女性。对所有352名女性进行抗心磷脂抗体(aCL)、抗β2糖蛋白I(abeta2GPI)和狼疮抗凝物(LA)检测。前两种抗体采用ELISA法检测,最后一种采用基于活化部分凝血活酶时间(APPT)的检测方法。只有第二次阳性结果才将患者判定为抗磷脂抗体(aPL)阳性。针对心磷脂和β2糖蛋白I的抗体分为IgA、IgG和IgM三类进行分析,阳性的实验室标准为滴度高于40单位U/ml或高于第99百分位数。
在352名接受筛查的女性中,有13名患者(3.69%)符合抗磷脂综合征的标准。早期和晚期流产女性中抗磷脂综合征的发生率分别为1.33%和6.25%。最常见的抗体是狼疮抗凝物(LA)。在3名晚期流产女性中发现了所有三种抗体。在早产并发子痫前期和/或胎盘功能不全的女性中,抗磷脂综合征的发生率为2.58%。