摘要
目的探讨早发型重度子痫前期孕妇检测自身抗体的临床价值。方法选取2010年7月至2013年12月于本院产科住院治疗的重度子痫前期孕妇57例,联合检测自身抗体与抗心磷脂抗体。重度子痫前期的孕妇分为3组:早发型重度子痫前期组20例;晚发型重度子痫前期组27例;慢性高血压并发重度子痫前期10例,并选取正常妊娠晚孕组42例为对照组。同时进行了一般情况(年龄、血压、24 h尿蛋白定量)、肾功能指标(尿素氮、肌酐、尿酸和胱抑素C)、不良结局(子痫发作、心衰、低蛋白血症、S/D值异常增高、胎死宫内、新生儿死亡)的比较,并进行定期随访。结果重度子痫前期各组尿素氮、肌酐、尿酸和胱抑素C明显高于正常妊娠组,以早发型重度子痫前期组肾功能损害最严重。早发型子痫前期组自身抗体阳性率35%,晚发型子痫前期组阳性率11%,慢性高血压并发重度子痫前期组阳性率20%,正常妊娠晚孕组自身抗体检出阳性率7.14%。早发型子痫前期组与正常妊娠组及晚发型子痫前期组比较具有统计学差异。自身抗体阳性组病情重、不良结局发生率高。子痫前期各组及正常妊娠对照组抗心磷脂抗体Ig G、Ig M均为阴性。结论早发型子痫前期孕妇病情凶险,肾功能损害严重,新生儿出生体质量低。早发型重度子痫前期与自身免疫性疾病存在相关性,与抗心磷脂抗体无相关性。因此,建议对早发型重度子痫前期患者可常规进行自身抗体的检测,以更好地判断其病情严重程度及预后,并能筛选出自身免疫性疾病,以指导下一次妊娠。
The role of autoantibodies in relation to clinical characteristics, disease severity, and outcome of severe preeclampsia remains thus far unclear. This study designed to evaluate the association between early severe preeclampsia and the autoantibodies. Retrospective investigation and analysis were carried out in 57 pregnant women with severe preeclampsia and 42 normal pregnant women. We found that the positive rate of autoantibodies in normal group was 7.14%, in late severe preeclampsia was 11%, in preeclampsia superimposed upon chronic hypertension was 20%, in early severe preeclampsia was 35%. Compared with the normal group and late severe preeclampsia group, the positive rate of autoantibodies in early severe preeclampsia is significantly different（P 〈0.05）. Furthermore, autoantibody positive groups demonstrated severe clinical manifestations and high incidence of adverse outcome; anticardiolipin antibodies Ig G and Ig M were all not found in the every group of preeclampsia and normal pregnancy group. In conclusion, early onset severe preeclampsia is related with autoimmune diseases, but not anticardiolipin antibody. Therefore, in order to get better insight into the disease severity, to differential diagnosis of autoimmune diseases, to judge the prognosis and guide the next pregnancy, autoantibodies detection would be necessary for those early severe preeclampsia women.
出处
《免疫学杂志》
CAS
CSCD
北大核心
2014年第12期1087-1090,共4页
Immunological Journal
基金
国家自然科学基金项目(81070505)
