aGL阳性流产患者治疗120例报告

Report of treatment of 120 abortion patients with positive aCL

摘要:

目的通过对120例aCL阳性流产患者的回顾性研究.探讨流产与抗心磷脂抗体(aCL)的关系及aCL流产者的治疗方法.方法242例因自然流产住院的患者,采用免疫金标法测定aCL(IgA、IgG、IgM),对aCL阳性流产者根据病情予以传统治疗或ApS治疗,追踪妊娠结局.结果120例aCL阳性流产者治疗后,84例追踪到妊娠结局,成功率70.24%,其中APS治疗成功率71.64%.1次流产的患者传统治疗成功率91.67%,APS治疗成功率77.14%,两者无统计学差异(P＞0.05);2次及2次以上流产患者,传统治疗5例,无1例成功,APS治疗成功率65.63%,两者有显著性差异(P＜0.05).结论aCL阳性流产患者的APS治疗成功率71.64%,尤其对于2次及2次以上流产患者,成功率明显高于传统治疗(P＜0.05).aCL阳性流产患者治疗后,结局明显改善,与对照组比较无显著性差异(P＞0.05).根据aCL和血液粘稠度选用强的松和/或小剂量阿司匹林作为常规治疗,疗效不好者加用低分子肝素和/或蓉生静丙治疗,效果显著.

Abstract:

Objective: To investigate the relationship between abortion and anticardiolipin antibody (aCL) and to establish effective treatment for 120 abortion patients with positive aCL through retrospective analysis. Methods: 242 patients who hospitalizied in our hospital because of abortion tested aCL(IgA?IgG?IgM) through the method of immune golden standard. Results: In all 242 patients, 120 was positive in aCL, 84 of the 120 patients traced pregnancy outcomes with successful rate 70.24%, and the successful rate in the APS therapy group 71.64%. For people only abortion once successful rate with APS therapy 77.14%, while conservative treatment 91.67%. No significant difference in these two groups (P >0.05). while for people with more than two times of abortions, the successful rate in those with APS therapy 65.63%, significantly higher than those with conservative treatment who had no live birth (P >0.05). Conclusions: Successful rate of aCL positive patient with APS therapy is 71.64%, especially to abortion more than two times. The successful rate of APS therapy is significant higher than those with traditional treatment (P <0.05). The pregnancy outcomes in the aCL positive patient with therapy are similar to those with aCL negative. We choose prednisone plus low-dose of aspirin as the routine therapy concerning aCL and coagulate stasis of blood, while to those with unsatisfactory curative effect, we treat with low-molecule-weight heparin and/or intravenous immunolglobulin, and therapeutic effect is obvious.