Marco P, Lucas J, Alonso A, Pérez Vázquez J, Fernández P, Victoria C, García M C, Calatayud R
Servicio de Hematología, Unidad de Hemostasia y Trombosis, Hospital General Universitario, Alicante.
Sangre (Barc). 1995 Oct;40(5):389-92.
To discover the prevalence of antiphospholipid antibodies in women with a history of repeated miscarriages. Therapy evaluation of aspirin and prednisone to achieve living term foetus from women in whom antiphospholipid antibodies had been detected and who had become pregnant again.
82 consecutive women with history of at least of two miscarriages, with no live foetus in either case. 14 women positive for antiphospholipid antibodies who had become pregnant again (group of therapy evaluation), were treated with aspirin (125 mg/d) and prednisone (20 mg/d). 60 normal pregnant women (control group). Lupus anticoagulant evaluation: APTT tests caolin clotting time and APTT system neutralized with platelet phospholipids. Antiphospholipid antibodies: ELISA test.
13.4% were positive to antiphospholipid antibodies (ELISA), and 2.4% were positive in both positive in both test. Therapy evaluation: 75.5% (11 cases) of pregnancies were successful (normal foetus), 14% (2 cases) of fetal losses, and 7% (1 case) of foetal malformations (acranius).
In our study the antiphospholipid antibodies represent one of the main causes of repeated foetal losses. We recommended in cases of infertile women to test for antiphospholipid antibodies regularly. We confirm the effectiveness of the therapy (aspirin and prednisone) in achieving successful pregnancies in patients with a history of infertility.
探讨有反复流产史女性抗磷脂抗体的患病率。对检测出抗磷脂抗体且再次怀孕的女性使用阿司匹林和泼尼松进行治疗评估，以实现足月分娩。
连续纳入82例至少有两次流产史且均无活产胎儿的女性。14例抗磷脂抗体阳性且再次怀孕的女性（治疗评估组），接受阿司匹林（125mg/d）和泼尼松（20mg/d）治疗。60例正常孕妇作为对照组。狼疮抗凝物评估：采用活化部分凝血活酶时间（APTT）检测高岭土凝血时间以及用血小板磷脂中和的APTT系统。抗磷脂抗体检测：采用酶联免疫吸附测定（ELISA）法。
抗磷脂抗体（ELISA法）阳性率为13.4%，两项检测均阳性率为2.4%。治疗评估：75.5%（11例）的妊娠成功（胎儿正常），14%（2例）发生胎儿丢失，7%（1例）出现胎儿畸形（无脑儿）。
在我们的研究中，抗磷脂抗体是反复胎儿丢失的主要原因之一。我们建议对不孕女性定期检测抗磷脂抗体。我们证实了该治疗方法（阿司匹林和泼尼松）对有不孕史患者实现成功妊娠的有效性。
