目的

：很多复发性流产患者病因不明。自身免疫过程参与流产发病过程。ANA在这一过程中起到的作用是不明确的。为了解决这方面的证据不足，我们探讨了抗核抗体(ANA)在不明原因复发性流产中临床意义。

方法

：我们对2005年9月到2012年5月68例复发性流产患者与60例健康患者进行了研究。所有病例均应用免疫荧光法检测ANA，以1:80及以上滴度为阳性。我们对ANA阴性及阳性复发性流产患者进行比较。

结果

：复发性流产患者ANA阳性率为35.3%，明显高于健康对照组。ANA阳性患者比ANA阴性患者有更高的流产率，更低的成功妊娠率(p=0.013)。ANA滴度与复发性流产明显相关(p<0.05, r=0.724)，但与成功妊娠无相关性(p=0.054).

结论

：ANA阳性预示着不利妊娠结局。我们的研究结果表明，ANA滴度是一个有用的复发性流产次数预测指标。因此，ANA检测是一个潜在的预后工具，这种情况值得进一步研究。

END

附原文：

OBJECTIVE

:The etiology of recurrent pregnancy loss (RPL) is unknown in a significant proportion of patients. Autoimmune processes have been implicated in the pathogenesis. The role of antinuclear antibody (ANA) in this context is largely undetermined. In an attempt to address the lack of evidence in this area, we explored the clinical significance of antinuclear antibody (ANA) in unexplained RPL.

METHODS

:We studied 68 patients with RPL and 60 healthy controls from September 2005 to May 2012. All subjects were tested for ANA by immunofluorescence testing, and a titer of 1: 80 and above was

considered positive. We compared the pregnancy outcome between the ANA positive and ANA negative RPL cases.RESULTS:The incidence of ANA positivity among the cases (35.3%) was significantly higher than the controls (13.3%) (p=0.005). ANA positive cases showed significantly higher number of RPL (p=0.006) and lower number of successful pregnancies (p=0.013) compared to the ANA negative cases . The ANA titre had a significant association with the number of RPL (p<0.05, r=0.724) but not with the number of successful pregnancies (p=0.054)

RESULTS

:The incidence of ANA positivity among the cases (35.3%) was significantly higher than the controls (13.3%) (p=0.005). ANA positive cases showed significantly higher number of RPL (p=0.006) and lower number of successful pregnancies (p=0.013) compared to the ANA negative cases . The ANA titre had a significant association with the number of RPL (p<0.05, r=0.724) but not with the number of successful pregnancies (p=0.054)

CONCLUSION

:ANA positivity predicts a less favorable pregnancy outcome in RPL. Our findings suggest that the ANA titre is a useful positive predictor of the number of RPL. Hence, ANA test is a potential prognostic tool for this condition which merits further research.

引自：Sakthiswary R1，et al.Clin Ter. 2015;166(2):e98-101. doi: 10.7417/T.2015.1827.