Shimada Shigeki, Yamada Hideto, Atsumi Tatsuya, Yamada Takashi, Sakuragi Noriaki, Minakami Hisanori
Department of Obstetrics and Gynecology Hokkaido University Graduate School of Medicine Sapporo Japan.
Women's Health Educational System Hokkaido University Graduate School of Medicine Sapporo Japan.
Reprod Med Biol. 2010 Jun 15;9(4):217-221. doi: 10.1007/s12522-010-0056-3. eCollection 2010 Dec.
We encountered a woman who had a history of repeated fetal losses and positive tests for lupus anticoagulant, phosphatidylserine-dependent antiprothrombin (aPS/PT) IgG, IgM and kininogen-dependent antiphosphatidylethanolamine (aPE) IgG, IgM. Her previous pregnancy had ended in intrauterine fetal death at 24 weeks of gestation despite a therapy of low-dose aspirin, prednisolone and danaparoid. During the present pregnancy, she was treated with repeated intravenous infusions of immunoglobulin (IVIg) together with low-dose aspirin, prednisolone and heparin. When thrombocytopenia developed, she delivered a female baby weighing 2,152 g at 34 weeks of gestation by cesarean section. Titers of aPS/PT IgM and aPE IgM were reduced or maintained at low levels by repeated IVIg therapies. The IVIg therapy might be effective for aspirin-heparinoid-resistant antiphospholipid syndrome.
我们遇到一名有反复流产史且狼疮抗凝物、磷脂酰丝氨酸依赖性抗凝血酶原（aPS/PT）IgG、IgM以及激肽原依赖性抗磷脂酰乙醇胺（aPE）IgG、IgM检测呈阳性的女性。尽管接受了低剂量阿司匹林、泼尼松龙和达那肝素治疗，她之前的妊娠仍在妊娠24周时以宫内胎儿死亡告终。在本次妊娠期间，她接受了反复静脉输注免疫球蛋白（IVIg）治疗，同时联合低剂量阿司匹林、泼尼松龙和肝素。当出现血小板减少症时，她在妊娠34周时通过剖宫产分娩了一名体重2152g的女婴。通过反复IVIg治疗，aPS/PT IgM和aPE IgM的滴度降低或维持在低水平。IVIg治疗可能对阿司匹林 - 类肝素抵抗的抗磷脂综合征有效。
