妊娠期高血压患者抗磷脂抗体水平与妊娠结局的关系研究
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摘要
目的:研究妊娠期高血压(HDCP)患者抗心磷脂抗体(ACA)及抗β_2-糖蛋白1(β_2-GP1)抗体水平与妊娠结局的关系,深入探讨抗磷脂抗体(APA)在HDCP发病中的作用,为临床预防及治疗HDCP提供新的理论依据。方法:选择在本院接受常规产检的妊娠期高血压疾病孕妇,采用酶联免疫吸附法(ELISA)检测孕妇ACA及抗β_2-GP1抗体水平,根据ELISA法检测结果分组,观察组A为仅ACA阳性孕妇,观察组B仅抗β_2-GP1抗体阳性孕妇,对照组为ACA及抗β_2-GP1抗体均阴性孕妇,每组均纳入30例。分析三组患者不良妊娠结局,以观察组A和观察组B为对象进行研究,分析APA水平与妊娠结局的相关性,分析不同抗磷脂抗体间相关性。结果:观察A组不良妊娠结局总发生率为46.67%,明显高于观察组A(36.66%)和对照组(10.00%),三组患者不良妊娠结局比较差异有统计学意义(P<0.05)。观察组A和观察组B两组患者ACA-IgM平均为(11.46±4.51)GPLU/mL、ACA-IgG平均为(9.42±3.51)MPLU/mL、抗β_2-GP1抗体平均为(104.63±21.83)U/mL。抗β_2-GPI抗体与围产儿死亡呈正相关(P<0.05),ACA-IgM、ACA-IgG和抗β_2-GP1抗体均与早产呈正相关(P<0.05),ACA-IgM与FGR呈正相关(P<0.05)。HDCP患者的ACA-IgG、ACA-IgM和抗β_2-GP1抗体三者两两间均呈正相关(P<0.05)。结论:HDCP患者ACA及抗β_2-GP1抗体与不良妊娠结局具有一定相关性,APA水平的检测对预测不良妊娠结局具有一定参考。
Objective:To study the relationship between antiphospholipid antibody(ACA)and anti beta 2-glycoprotein 1(β_2-GP1)antibody level and pregnancy outcome in patients with pregnancy induced hypertension(HDCP),to explore the role of anti phospholipid antibody(APA)in the pathogenesis of HDCP,and provide a new theoretical basis for the clinical prevention and treatment of HDCP.Method:The maternal ACA and β_2-GP1 antibody levels were detected by enzyme linked immunosorbent assay(ELISA)in pregnant women of our hospital.The results were grouped according to the results of ELISA,the observation group A was only ACA positive,the observation group B was only resistant to positive pregnant women with β_2-GP1 antibody,and the control group was ACA and β_2-GP1 resistance,all negative pregnant women,30 cases in each group.The adverse pregnancy outcomes of the three groups were analyzed.The study was conducted in observation group A and B,the correlation between antiphospholipid antibody level and pregnancy outcome was analyzed,and the correlation between different antiphospholipid antibodies was analyzed.Result:The total incidence of undesirable pregnancy outcome in observation group A was 46.67%,which was significantly higher than that in observation group B(36.66%)and control group(10.00%).There was significant difference in adverse pregnancy outcomes in the three group(P<0.05).The level of ACA-IgM in the two groups of group A and group B was(11.46±4.51)GPLU/mL, ACA-IgG was(9.42±3.51)MPLU/mL andβ_2-GP1 was(104.63±21.83)U/Ml,there was a positive correlation between theβ_2-GP1 antibody and perinatal mortality(P<0.05);ACA-IgM,ACA-IgG and β_2-GP1 antibody were positively correlated with preterm labor(P<0.05);ACA-IgM and FGR were positively correlated (P<0.05).There was a positive correlation between ACA-IgG,ACA-IgM andβ_2-GP1 antibody in HDCP patients(P<0.05).Conclusion:There is a certain correlation between ACA andβ_2-GP1 antibody in HDCP patients and bad pregnancy outcome.The detection of APA level has a certain reference to the prediction of bad pregnancy outcome.
Objective:To study the relationship between antiphospholipid antibody(ACA)and anti beta 2-glycoprotein 1(β_2-GP1)antibody level and pregnancy outcome in patients with pregnancy induced hypertension(HDCP),to explore the role of anti phospholipid antibody(APA)in the pathogenesis of HDCP,and provide a new theoretical basis for the clinical prevention and treatment of HDCP.Method:The maternal ACA and β_2-GP1 antibody levels were detected by enzyme linked immunosorbent assay(ELISA)in pregnant women of our hospital.The results were grouped according to the results of ELISA,the observation group A was only ACA positive,the observation group B was only resistant to positive pregnant women with β_2-GP1 antibody,and the control group was ACA and β_2-GP1 resistance,all negative pregnant women,30 cases in each group.The adverse pregnancy outcomes of the three groups were analyzed.The study was conducted in observation group A and B,the correlation between antiphospholipid antibody level and pregnancy outcome was analyzed,and the correlation between different antiphospholipid antibodies was analyzed.Result:The total incidence of undesirable pregnancy outcome in observation group A was 46.67%,which was significantly higher than that in observation group B(36.66%)and control group(10.00%).There was significant difference in adverse pregnancy outcomes in the three group(P<0.05).The level of ACA-IgM in the two groups of group A and group B was(11.46±4.51)GPLU/mL, ACA-IgG was(9.42±3.51)MPLU/mL andβ_2-GP1 was(104.63±21.83)U/Ml,there was a positive correlation between theβ_2-GP1 antibody and perinatal mortality(P<0.05);ACA-IgM,ACA-IgG and β_2-GP1 antibody were positively correlated with preterm labor(P<0.05);ACA-IgM and FGR were positively correlated (P<0.05).There was a positive correlation between ACA-IgG,ACA-IgM andβ_2-GP1 antibody in HDCP patients(P<0.05).Conclusion:There is a certain correlation between ACA andβ_2-GP1 antibody in HDCP patients and bad pregnancy outcome.The detection of APA level has a certain reference to the prediction of bad pregnancy outcome.
引文
[1]金美媛,郑能能,熊智慧.中西医结合治疗重度子痫前期与子痫型妊娠期高血压的临床分析[J].中华中医药学刊,2018,36(4):949-951.
[2]Wang Y,Shi D,Chen L.Lipid profile and cytokines in hypertension of pregnancy:A comparison of preeclampsia therapies[J].J Clin Hypertens(Greenwich),2018,20(2):394-399.
[3]谢桂英,马玉燕.拉贝洛尔对中重度妊娠期高血压疾病患者心肾功能及妊娠结局的影响及机制[J].山东医药,2017,57(21):74-76.
[4]黄月婷,张建平.妊娠合并症及并发症与血液指标异常的观察与处理[J].实用妇产科杂志,2016,32(9):655-658.
[5]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013.
[6]魏继文,吴萍.妊娠期高血压疾病相关影响因素分析[J].重庆医学,2016,45(22):3078-3080.
[7]Wang Y,Liu R X,Liu H.Association of adiponectin gene polymorphisms with hypertensive disorder complicating pregnancy and disorders of lipid metabolism[J].Genet Mol Res,2015,14(4):15213-15223.
[8]倪琰琰,程蔚蔚.早发型子痫前期的预测研究进展[J].东南大学学报(医学版),2016,35(1):135-138.
[9]刘利华,徐勇.甲状腺过氧化物酶抗体和球蛋白抗体与妊娠不良结局的关系[J].广东医学,2015,36(7):1053-1055.
[10]Zhong W,Peng H,Tian A.Expression of miRNA-1233 in placenta from patients with hypertensive disorder complicating pregnancy and its role in disease pathogenesis[J].Int J Clin Exp Med,2015,8(6):9121-9127.
[11]林静,李红.妊娠期高血压疾病孕妇血清尿酸监测的临床意义[J].中国妇产科临床杂志,2016,17(6):546-548.
[12]Zhou J,Xiao X M,Wu Y H.Expression of interferon-γin decidual natural killer cells from women with hypertensive disorder complicating pregnancy[J].J Obstet Gynaecol Res,2014,40(3):670-676.
[13]王玉杰,张立军,吴荣秀.肾脏血流动力学与血管内皮功能及妊娠期高血压疾病相关性的研究[J].中国妇幼保健,2014,29(7):1006-1008.
[14]Chen Y S,Shen L,Mai R Q.Levels of microRNA-181b and plasminogen activator inhibitor-1 are associated with hypertensive disorders complicating pregnancy[J].Exp Ther Med,2014,8(5):1523-1527.
[15]冯永亮,彭婷婷,王芳.妊娠期高血压疾病对出生结局的影响及相关因素[J].中华疾病控制杂志,2014,18(2):131-134.
[16]朱彩丹.妊娠期高血压患者随机尿蛋白/肌酐比值水平与不良妊娠结局的关系研究[J].中国全科医学,2015,18(10):1168-1171.
[17]怀莹莹,丁虹娟.妊娠晚期甘油三酯及总胆固醇对妊娠结局的影响[J].中国妇产科临床杂志,2015,16(5):424-426.
[18]李燕,楼月兰.妊娠期高血压严重程度对母儿结局的影响[J].广东医学,2016,37(15):2319-2321.
[19]范玉芹,李磊,王谢桐.免疫调控在子痫前期早期干预中的作用和评价[J].中国实用妇科与产科杂志,2014,30(10):771-774.
[20]张艳梅,杜彦玫,王冬梅.孕妇妊娠期高血压合并感染围产儿预后的研究[J].中华医院感染学杂志,2014,24(4):986-987,990.
[2]Wang Y,Shi D,Chen L.Lipid profile and cytokines in hypertension of pregnancy:A comparison of preeclampsia therapies[J].J Clin Hypertens(Greenwich),2018,20(2):394-399.
[3]谢桂英,马玉燕.拉贝洛尔对中重度妊娠期高血压疾病患者心肾功能及妊娠结局的影响及机制[J].山东医药,2017,57(21):74-76.
[4]黄月婷,张建平.妊娠合并症及并发症与血液指标异常的观察与处理[J].实用妇产科杂志,2016,32(9):655-658.
[5]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013.
[6]魏继文,吴萍.妊娠期高血压疾病相关影响因素分析[J].重庆医学,2016,45(22):3078-3080.
[7]Wang Y,Liu R X,Liu H.Association of adiponectin gene polymorphisms with hypertensive disorder complicating pregnancy and disorders of lipid metabolism[J].Genet Mol Res,2015,14(4):15213-15223.
[8]倪琰琰,程蔚蔚.早发型子痫前期的预测研究进展[J].东南大学学报(医学版),2016,35(1):135-138.
[9]刘利华,徐勇.甲状腺过氧化物酶抗体和球蛋白抗体与妊娠不良结局的关系[J].广东医学,2015,36(7):1053-1055.
[10]Zhong W,Peng H,Tian A.Expression of miRNA-1233 in placenta from patients with hypertensive disorder complicating pregnancy and its role in disease pathogenesis[J].Int J Clin Exp Med,2015,8(6):9121-9127.
[11]林静,李红.妊娠期高血压疾病孕妇血清尿酸监测的临床意义[J].中国妇产科临床杂志,2016,17(6):546-548.
[12]Zhou J,Xiao X M,Wu Y H.Expression of interferon-γin decidual natural killer cells from women with hypertensive disorder complicating pregnancy[J].J Obstet Gynaecol Res,2014,40(3):670-676.
[13]王玉杰,张立军,吴荣秀.肾脏血流动力学与血管内皮功能及妊娠期高血压疾病相关性的研究[J].中国妇幼保健,2014,29(7):1006-1008.
[14]Chen Y S,Shen L,Mai R Q.Levels of microRNA-181b and plasminogen activator inhibitor-1 are associated with hypertensive disorders complicating pregnancy[J].Exp Ther Med,2014,8(5):1523-1527.
[15]冯永亮,彭婷婷,王芳.妊娠期高血压疾病对出生结局的影响及相关因素[J].中华疾病控制杂志,2014,18(2):131-134.
[16]朱彩丹.妊娠期高血压患者随机尿蛋白/肌酐比值水平与不良妊娠结局的关系研究[J].中国全科医学,2015,18(10):1168-1171.
[17]怀莹莹,丁虹娟.妊娠晚期甘油三酯及总胆固醇对妊娠结局的影响[J].中国妇产科临床杂志,2015,16(5):424-426.
[18]李燕,楼月兰.妊娠期高血压严重程度对母儿结局的影响[J].广东医学,2016,37(15):2319-2321.
[19]范玉芹,李磊,王谢桐.免疫调控在子痫前期早期干预中的作用和评价[J].中国实用妇科与产科杂志,2014,30(10):771-774.
[20]张艳梅,杜彦玫,王冬梅.孕妇妊娠期高血压合并感染围产儿预后的研究[J].中华医院感染学杂志,2014,24(4):986-987,990.
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