摘要
复发性流产（recurrent spontaneous abortion,RSA）是育龄期女性妊娠期常见的并发症之一,临床上通常将其定义为连续3次或3次以上在妊娠28周之前的胎儿丢失[1]。据调查研究显示,RSA约占生育期妇女的2%～3%[2],染色体异常、生殖器解剖结构异常、感染因素、内分泌、易栓状态、免疫异常均与RSA的发生相关,其中免疫异常又在RSA发生中起到了不可忽视的作用。
Recurrent spontaneous abortion is one of the common complications in women of childbearing age during pregnancy. The immune factor accounts for a large proportion of many causes. Antiphospholipid antibody syndrome is the most common type of acquired thrombophilia disease. Autoimmune diseases that cause thrombosis and obstetric complications under the action of antibodies are also the most common type of immune-related recurrent abortion. At present,there is no unified opinion on the treatment of this disease,especially the treatment of immunoglobulins and other drugs like glucocorticoid.Here we reviewed the progress of diagnosis and treatment of antiphospholipid antibody-related recurrent abortions and retrospectively analyzed and summarized the drug regimens and pregnancy outcomes of this disease with pregnancy patients in our hospital. A total of 75 patients were included. According to their clinical manifestations and laboratory results,these patients were basically divided into two categories：classical antiphospholipid syndrome and non-classical antiphospholipid syndrome. The latter was further divided into serum-negative antiphospholipid syndrome and antiphospholipid antibody-related recurrent abortion patients based on their clinical manifestations and antiphospholipid antibody results. The patients were divided into four categories： aspirin ＋ hydroxychloroquine,aspirin ＋ low molecular weight heparin,aspirin ＋ low molecular weight heparin ＋ hydroxychloroquine,aspirin ＋ hydroxychloroquine ＋ low molecular weight heparin ＋ low dose glucocorticoids. Among them,aspirin ＋ hydroxychloroquine ＋ low molecular weight heparin ＋ low-dose glucocorticoid treatment regimen was most commonly used. Most of the patients who received the above different treatment regimens achieved full-term infants,and a small number of patients had adverse pregnancy outcomes,such as premature delivery,placental abruption,eclampsia,and fetal malformation. And adverse pregnancy outcomes also occurred in this group. It might be related to the severity of the disease and the potential adverse effects of maternal fetal. However,further statistical analysis is needed for the risk factors affecting the pregnancy outcome of this part of patients.
作者
李欣艺
赵金霞
刘湘源
LI Xin-yi;ZHAO Jin-xia;LIU Xiang-yuan(Department of Rheumatology and Immunology,Peking University Third Hospital,Beijing 100191,China)
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2018年第6期956-961,共6页
Journal of Peking University:Health Sciences
关键词
复发性流产
抗体
抗磷脂
治疗结果
Recurrent spontaneous abortion
Antibodies
antiphospholipid
Treatment outcome
