Tonello Marta, Hoxha Ariela, Mattia Elena, Zambon Alessandra, Visentin Silvia, Cerutti Alessia, Ghirardello Anna, Milanesi Ornella, Ruffatti Amelia
Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
Gynaecology and Obstetrics Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy.
Clin Rheumatol. 2017 May;36(5):1155-1160. doi: 10.1007/s10067-017-3572-2. Epub 2017 Feb 15.
Congenital heart block (CHB) is an autoantibody mediated disorder presumably caused by placental transmission of maternal autoantibodies to Ro/SSA 52 kd, p200, Ro/SSA 60 kd, La/SSB ribonucleoproteins. This study investigated the clinical significance of isolated anti-Ro/SSA 52 kd, anti-p200, anti-Ro/SSA 60 kd, and anti-La/SSB antibodies in positive pregnant patients. One hundred sixty-three pregnant women positive to anti-Ro/SSA 52 kd and/or anti-Ro/SSA 60 kd and/or anti-La/SSB antibodies were prospectively enrolled in the study. Anti-Ro52, anti-Ro60, anti-p200, and anti-La antibodies were assayed using home-made ELISA assays. Isolated antibody positivity was found in 25 women (15.3%), while multiple antibody positivity in 138 (84.7%). Twenty-four developed CHB, and the 139 had a favorable pregnancy outcome. The prevalence of isolated anti-Ro/SSA 60 kd antibodies was significantly higher (p < 0.046) as the prevalence of lower mean antibody titers (p < 0.0001) in the later group. Confirmation of these results by large-scale studies could lead clinicians to recommend less stringent fetal echocardiography monitoring in women with isolated anti-Ro/SSA 60 kd antibodies.
先天性心脏传导阻滞（CHB）是一种自身抗体介导的疾病，可能是由于母体自身抗体经胎盘传递至Ro/SSA 52kd、p200、Ro/SSA 60kd、La/SSB核糖核蛋白所致。本研究调查了抗Ro/SSA 52kd、抗p200、抗Ro/SSA 60kd和抗La/SSB抗体在阳性孕妇中的临床意义。163例抗Ro/SSA 52kd和/或抗Ro/SSA 60kd和/或抗La/SSB抗体阳性的孕妇前瞻性纳入本研究。采用自制酶联免疫吸附测定法检测抗Ro52、抗Ro60、抗p200和抗La抗体。25名女性（15.3%）发现有单一抗体阳性，138名（84.7%）为多种抗体阳性。24例发生先天性心脏传导阻滞，139例妊娠结局良好。单一抗Ro/SSA 60kd抗体的患病率显著更高（p<0.046），后一组的平均抗体滴度更低（p<0.0001）。通过大规模研究证实这些结果可能会使临床医生建议对单一抗Ro/SSA 60kd抗体的女性进行不太严格的胎儿超声心动图监测。
