Lin Q D
Renji Hospital of Shanghai Second Medical University.
Zhonghua Fu Chan Ke Za Zhi. 1993 Nov;28(11):674-7, 702.
Two hundred and forty five patients with recurrent abortions were studied for autoantibodies in this paper. The total positive rate of autoantibodies was found to be 18.4% (45/245). The presence of antiphospholipid antibodies was in 33 (13.5%), antinuclear antibodies in 17 (6.9%) and anti-ENA in 7 (2.9%) patients. According to the clinical data, these 45 patients were classified into three types: (1) cases with antiphospholipid antibodies; (2) cases with anti-ENA (SLE); (3) cases with simple antinuclear antibodies. All the patients except SLE cases were treated with low-dose prednisone (5 mg/day) and aspirin (60-80 mg/day). The total pregnancy success rate was 80.0%. Excluding SLE cases, the success rate was up to 92.9%. The outcome of pregnancy was usually related to whether the autoantibodies especially LAC turned negative or not. Hemorheology and coagulative state in 19 patients with autoantibodies revealed hypercoagulative condition. It suggests that autoantibodies may cause intravascular coagulation leading to recurrent abortions.
本文对245例复发性流产患者进行了自身抗体研究。发现自身抗体总阳性率为18.4%(45/245)。抗磷脂抗体阳性者33例(13.5%),抗核抗体阳性者17例(6.9%),抗可提取性核抗原抗体阳性者7例(2.9%)。根据临床资料,将这45例患者分为三型:(1)抗磷脂抗体型;(2)抗可提取性核抗原抗体(系统性红斑狼疮)型;(3)单纯抗核抗体型。除系统性红斑狼疮患者外,所有患者均接受小剂量泼尼松(5毫克/天)和阿司匹林(60 - 80毫克/天)治疗。总妊娠成功率为80.0%。排除系统性红斑狼疮患者后,成功率高达92.9%。妊娠结局通常与自身抗体尤其是狼疮抗凝物是否转阴有关。对19例自身抗体阳性患者的血液流变学和凝血状态检测显示为高凝状态。这表明自身抗体可能导致血管内凝血,进而引起复发性流产。