Rai R S, Regan L, Clifford K, Pickering W, Dave M, Mackie I, McNally T, Cohen H
Department of Obstetrics and Gynaecology, St. Mary's Hospital Medical School, London, UK.
Hum Reprod. 1995 Aug;10(8):2001-5. doi: 10.1093/oxfordjournals.humrep.a136224.
Five hundred consecutive women (median age 33 years; range 19-45) with a history of recurrent miscarriage (median 4; range 3-16) were screened for the presence of antiphospholipid antibodies (APA)-lupus anticoagulant (LA) and/or anticardiolipin antibodies (ACA). The prevalence of persistently positive tests for LA was 9.6% and for immunoglobulin G (IgG) and immunoglobulin M (IgM) ACA was 3.3 and 2.2% respectively. Only seven women (1.4%) were LA and ACA positive. Repeat testing, after an interval of at least 8 weeks, demonstrated that only 65.7% of LA positive, 36.6% IgG ACA positive and 36.0% IgM ACA positive women on initial testing had a second positive test result. The dilute Russell's viper venom time detected the LA significantly more often than either the activated partial thromboplastin time or the kaolin clotting time (P < 0.001). There was no difference in the gestation of previous miscarriages between APA positive and APA negative women. There was no difference in the plasma beta 2-glycoprotein-I concentrations between APA positive and APA negative women with miscarriages and normal women. All women with a history of recurrent miscarriage should be tested for the presence of both LA and ACA. A second confirmatory test should be performed in those with an initial positive test result.
对500例有复发性流产史（中位数为4次；范围3 - 16次）的连续女性（中位年龄33岁；范围19 - 45岁）进行抗磷脂抗体（APA）-狼疮抗凝物（LA）和/或抗心磷脂抗体（ACA）筛查。LA持续阳性检测的患病率为9.6%，免疫球蛋白G（IgG）和免疫球蛋白M（IgM）ACA持续阳性检测的患病率分别为3.3%和2.2%。仅7名女性（1.4%）LA和ACA均为阳性。在间隔至少8周后重复检测显示，初次检测时LA阳性的女性中只有65.7%、IgG ACA阳性的女性中只有36.6%、IgM ACA阳性的女性中只有36.0%第二次检测仍为阳性。稀释的罗素蝰蛇毒时间比活化部分凝血活酶时间或高岭土凝血时间更常检测到LA（P < 0.001）。APA阳性和APA阴性女性既往流产时的孕周无差异。有流产史的APA阳性和APA阴性女性与正常女性之间血浆β2 -糖蛋白 - I浓度无差异。所有有复发性流产史的女性均应检测LA和ACA。初次检测结果为阳性的女性应进行第二次确证检测。
