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妊娠丢失与抗磷脂结合蛋白自身抗体

Pregnancy loss and autoantibodies against phospholipid-binding proteins.

作者信息

Falcón C R, Martinuzzo M E, Forastiero R R, Cerrato G S, Carreras L O

机构信息

Department of Hematology, Favaloro Foundation, Buenos Aires, Argentina.

出版信息

Obstet Gynecol. 1997 Jun;89(6):975-80. doi: 10.1016/s0029-7844(97)00115-4.

Abstract

OBJECTIVE

To evaluate the relationship between antibodies against beta 2-glycoprotein I or prothrombin and pregnancy losses in women with antiphospholipid antibodies.

METHODS

Women with antiphospholipid antibodies, (lupus anticoagulant and/or anticardiolipin antibodies), with (n = 41) and without (n = 61) a history of pregnancy loss were evaluated. Thirty-one out of the forty-one patients with pregnancy loss had early miscarriages (at less than 13 weeks) and ten patients had late miscarriages. Immunoglobulin (Ig)-G and IgM anti-beta 2-glycoprotein I and anti-prothrombin antibodies were measured by an enzyme-linked immunosorbent assay method.

RESULTS

A significant association between pregnancy loss and positive IgM anti-beta 2-glycoprotein I antibodies was found (odds ratio 2.6; 95% confidence interval 1.03, 6.6; P = .043). Women with late pregnancy loss had higher levels of both IgG and IgM anti-beta 2-glycoprotein I antibodies compared with controls (P < .05). There was a good correlation between anticardiolipin and anti-beta 2-glycoprotein I antibodies levels (IgG: r = 0.75; IgM: r = 0.73). In contrast, there was no correlation between the levels of anticardiolipin or anti-beta2-glycoprotein I antibodies and the levels of anti-prothrombin antibodies. Furthermore, the presence of anti-prothrombin antibodies was not associated with a history of pregnancy loss.

CONCLUSION

The result of our study shows that there is a relationship between the presence of IgM anti-beta 2-glycoprotein I and previous miscarriages in women with anti-phospholipid antibodies.

摘要

目的

评估抗β2-糖蛋白I或凝血酶原抗体与抗磷脂抗体阳性女性妊娠丢失之间的关系。

方法

对患有抗磷脂抗体(狼疮抗凝物和/或抗心磷脂抗体)且有(n = 41)或无(n = 61)妊娠丢失史的女性进行评估。41例有妊娠丢失史的患者中,31例发生早期流产(孕周小于13周),10例发生晚期流产。采用酶联免疫吸附测定法检测免疫球蛋白(Ig)-G和IgM抗β2-糖蛋白I及抗凝血酶原抗体。

结果

发现妊娠丢失与IgM抗β2-糖蛋白I抗体阳性之间存在显著关联(比值比2.6;95%置信区间1.03, 6.6;P = .043)。与对照组相比,晚期妊娠丢失女性的IgG和IgM抗β2-糖蛋白I抗体水平均较高(P < .05)。抗心磷脂抗体与抗β2-糖蛋白I抗体水平之间存在良好相关性(IgG:r = 0.75;IgM:r = 0.73)。相比之下,抗心磷脂或抗β2-糖蛋白I抗体水平与抗凝血酶原抗体水平之间无相关性。此外,抗凝血酶原抗体的存在与妊娠丢失史无关。

结论

我们的研究结果表明,抗磷脂抗体阳性女性中IgM抗β2-糖蛋白I的存在与既往流产之间存在关联。

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