摘要：目的:评估无自身免疫性疾病的妇女中复发性胎儿丢失(RFL)与抗磷脂抗体(aPL)之间的关联强度，并检查关联程度是否随抗体类型或滴度以及胎儿丢失的时间而变化。

方法:我们在Medline和Current目录中搜索1975年至2003年间发表的与各种aPL相关的早期(小于13周)和晚期(小于24周)RFL的文章。在我们的荟萃分析中包括了已发表的病例对照、队列和横断面研究，评价为中度或重度。使用Cochrane审查管理器软件的随机效应模型生成95%置信区间的合并优势比。

结果:我们的分析包括25项研究。狼疮抗凝物(LAC)与晚期RFL病相关(OR7.79，95%CI2.30-26.45);LA的相关性比任何aPL都强。当纳入所有滴度时，IgG抗心磷脂抗体(aCL)与早期(OR3.56，95%CI1.48-8.59)和晚期RFL(OR3.57，95%CI2.26-5.65)均相关。将分析限制为仅包括中至高滴度的妇女时关联性增强(OR 4.68，95%CI2.96-7.40)。没有提取到关于低IgG aCL阳性的数据。IgM aCL与RFL晚期相关(OR 5.61，95%CI1.26-25.03)。早期RFL和抗β2糖蛋白I抗体之间没有关联(OR 2.12，95%CI0.69-6.53)。

结论:aPL与RFL之间的关联程度因aPL的类型而异。更多关于反复胎儿丢失与单独的IgM aCL以及低滴度IgG aCL之间关系的数据可能相关。抗β2-糖蛋白I抗体的检测价值仍有待确定。

附原文：OBJECTIVE: To assess the strength of association between recurrent fetal loss (RFL) and presence of antiphospholipid antibodies (aPL) in women without autoimmune disease, and to examine whether magnitude of association varies according to type or titer of antibody and timing of fetal loss. METHODS: We searched Medline and Current Contents for articles published between 1975 and 2003 with terms denoting early (less than 13 weeks) and late (less than 24 weeks) RFL associated with various aPL. Published case-control, cohort, and cross-sectional studies rated moderate or strong were included in our metaanalysis. Pooled odds ratios with 95% CI were generated using the random-effects models with Cochrane Review Manager software. RESULTS: Our analysis included 25 studies. Lupus anticoagulant (LAC) was associated with late RFL (OR 7.79, 95% CI 2.30-26.45); the association of LAC was stronger than that of any other aPL. IgG anticardiolipin antibodies (aCL), when combining all titers, were associated with both early (OR 3.56, 95% CI 1.48-8.59) and late RFL (OR 3.57, 95% CI 2.26-5.65). Restrictinganalysis to include only women with moderate to high titers increased the strength of association (OR 4.68, 95% CI 2.96-7.40). It was not possible to extract data on isolated low IgG aCL positivity. IgM aCL were associated with late RFL (OR 5.61, 95% CI 1.26-25.03). There was no association found between early RFL and anti-Beta2-glycoprotein I antibodies (OR 2.12, 95% CI 0.69-6.53). CONCLUSION: The magnitude of the association between aPL and RFL varies according to type of aPL. More data on the relationship between recurrent fetal loss and isolated IgM aCL as well as with low titer IgG aCL would be useful. The place of testing for anti-Beta2-glycoprotein I antibodies remains to be determined.

引自：Opatrny, L., M. David, S. R. Kahn, I. Shrier and E. Rey (2006). "Association between antiphospholipid antibodies and recurrent fetal loss in women without autoimmune disease: a metaanalysis."J Rheumatol33(11): 2214-2221.