Sakthiswary R, Rajalingam S, Norazman M R, Hussein H
Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Kuala Lumpur, Malaysia.
Department of Medicine, Putrajaya Hospital, 62250, Putrajaya, Malaysia.
Clin Ter. 2015;166(2):e98-101. doi: 10.7417/CT.2015.1827.
The etiology of recurrent pregnancy loss (RPL) is unknown in a significant proportion of patients. Autoimmune processes have been implicated in the pathogenesis. The role of antinuclear antibody (ANA) in this context is largely undetermined. In an attempt to address the lack of evidence in this area, we explored the clinical significance of antinuclear antibody (ANA) in unexplained RPL.
We studied 68 patients with RPL and 60 healthy controls from September 2005 to May 2012. All subjects were tested for ANA by immunofluorescence testing, and a titer of 1: 80 and above was considered positive. We compared the pregnancy outcome between the ANA positive and ANA negative RPL cases.
The incidence of ANA positivity among the cases (35.3%) was significantly higher than the controls (13.3%) (p=0.005). ANA positive cases showed significantly higher number of RPL (p=0.006) and lower number of successful pregnancies (p=0.013) compared to the ANA negative cases . The ANA titre had a significant association with the number of RPL (p<0.05, r=0.724) but not with the number of successful pregnancies (p=0.054).
ANA positivity predicts a less favorable pregnancy outcome in RPL. Our findings suggest that the ANA titre is a useful positive predictor of the number of RPL. Hence, ANA test is a potential prognostic tool for this condition which merits further research.
在相当一部分复发性流产（RPL）患者中，病因尚不清楚。自身免疫过程被认为与发病机制有关。在这种情况下，抗核抗体（ANA）的作用很大程度上尚未确定。为了弥补这一领域证据的不足，我们探讨了抗核抗体（ANA）在不明原因复发性流产中的临床意义。
2005年9月至2012年5月，我们研究了68例复发性流产患者和60例健康对照。所有受试者均通过免疫荧光检测法检测抗核抗体，滴度为1:80及以上被视为阳性。我们比较了抗核抗体阳性和阴性的复发性流产病例的妊娠结局。
病例组中抗核抗体阳性率（35.3%）显著高于对照组（13.3%）（p = 0.005）。与抗核抗体阴性病例相比，抗核抗体阳性病例的复发性流产次数显著更高（p = 0.006），成功妊娠次数更低（p = 0.013）。抗核抗体滴度与复发性流产次数有显著相关性（p < 0.05，r = 0.724），但与成功妊娠次数无关（p = 0.054）。
抗核抗体阳性预示着复发性流产患者的妊娠结局较差。我们的研究结果表明，抗核抗体滴度是复发性流产次数的一个有用的阳性预测指标。因此，抗核抗体检测是这种情况的一种潜在预后工具，值得进一步研究。
