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目的探讨抗β2糖蛋白Ⅰ(β2GPⅠ)抗体对抗磷脂综合征患者妊娠丢失及免疫调节治疗疗效的影响。方法将2006年6月至2009年12月在中南大学湘雅二医院产科住院治疗的抗磷脂综合征确诊患者共191例按不同抗体阳性分为3组:A组154例:抗心磷脂抗体(ACA)(+),β2GPⅠ(-);B组26例:ACA(+),β2GPⅠ(+);C组11例:ACA(-),β2GPⅠ(+)。分析各组的妊娠丢失率及免疫治疗的疗效。结果治疗前,A、B、C3组间妊娠丢失率(61.59%,69.84%,67.86%)差异无统计学意义(P>0.05)。经免疫调节治疗后,B组(46.15%)患者妊娠丢失率明显高于A组(22.08%),差异有统计学意义(P<0.05);C组(36.36%)与A组、B组比较差异无统计学意义(P>0.05)。结论抗β2GPⅠ抗体对抗磷脂综合征患者妊娠丢失率的影响与ACA相似;抗β2GPⅠ抗体(+)合并ACA(+)的抗磷脂综合征患者对免疫调节治疗的疗效欠佳。
Objective To investigate the effect of anti-β2GP Ⅰ antibodies on pregnancy loss and immunomodulatory therapy in patients with antiphospholipid syndrome. Methods From June 2006 to December 2009, 191 patients diagnosed with antiphospholipid syndrome admitted to the obstetrics department of Xiangya Second Hospital of Central South University were divided into three groups according to the different antibody positives: group A, 154 patients: anti-cardiolipin antibody ACA (+), β2GPⅠ (-); B group of 26 cases: ACA (+), β2GPⅠ (+); C group of 11 cases: ACA (-), β2GPⅠ (+). Analysis of each group of pregnancy loss and immunotherapy efficacy. Results Before treatment, the loss rate of pregnancy (61.59%, 69.84%, 67.86%) between A, B and C3 groups was not statistically significant (P> 0.05). After immunosuppressive therapy, the pregnancy loss rate in group B (46.15%) was significantly higher than that in group A (22.08%) (P <0.05); in group C (36.36%) compared with group A and group B The difference was not statistically significant (P> 0.05). Conclusion The anti-β2GPⅠ antibody has a similar effect on the pregnancy loss rate in patients with phospholipid syndrome as compared with ACA. The anti-phospholipid syndrome patients with anti-β2GPⅠ antibody (+) and ACA (+) have poor response to immunomodulatory therapy.