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目的探讨抗透明带抗体(ZPAb)和抗心磷脂抗体(ACA)对女性不孕及反复自然流产的影响。方法对原发性不孕256人,继发性不孕187人,原发性自然流产201人,继发性自然流产120人,用ELISA方法检测其血清中ACA和ZPAb,与225例健康妇女对照。结果对照组ACA阳性率为4.89%(11/225),ZPAb阳性率为2.22%(5/225),原发性不孕组与继发性不孕组ACA阳性率分别为24.22%(62/256)和28.88%(54/187),ZPAb阳性率分别为25.39%(65/256)和27.81%(52/187),与对照组比较均有显著性差异(P<0.01)。原发性自然流产组ACA和ZPAb阳性率分别为33.83%(68/201)和22.39%(45/201),与对照组相比有显著性差异(P<0.01);而继发性流产组中ACA和ZPAb阳性率分别为7.50%(9/120)和3.33%(4/120),与对照组比较无显著性差异(P>0.05);原发性流产组与继发性流产组间ACA和ZPAb的阳性率也有显著性差异(P<0.01)。结论ACA和ZPAb在导致原发性和继发性不孕方面均有明显影响;对原发性流产的发生有明显作用,而对继发性流产的影响意义不大。检测ACA、ZPAb可作为不孕及原发性流产病因诊断的一项指标,干涉其高血清浓度可望对这类疾病起到治疗作用。
Objective To investigate the effects of anti-zona pellucida (ZPAb) and anticardiolipin antibodies (ACA) on female infertility and recurrent spontaneous abortion. Methods 256 primary infertility, 187 secondary infertility, 201 primary spontaneous abortion and 120 secondary spontaneous abortion were collected. Serum ACA and ZPAb were detected by ELISA and 225 healthy women Control. Results The positive rate of ACA in control group was 4.89% (11/225), the positive rate of ZPAb was 2.22% (5/225). The positive rates of ACA in primary infertility group and secondary infertility group were 24.22% (62 / 256) and 28.88% (54/187) respectively. The positive rate of ZPAb was 25.39% (65/256) and 27.81% (52/187) respectively, which was significantly different from the control group (P <0.01). The positive rates of ACA and ZPAb in primary spontaneous abortion group were 33.83% (68/201) and 22.39% (45/201), respectively, which were significantly different from those in control group (P <0.01) The positive rates of ACA and ZPAb were 7.50% (9/120) and 3.33% (4/120) respectively in the control group, with no significant difference compared with the control group (P> 0.05). The positive rates of ACA and ZPAb between the primary abortion group and the secondary abortion group The positive rates of ACA and ZPAb were also significantly different (P <0.01). Conclusions Both ACA and ZPAb have a significant effect on primary and secondary infertility; they have a significant effect on the incidence of primary abortion, but have little effect on secondary abortion. The detection of ACA and ZPAb can be used as an indicator of the cause of infertility and primary abortion, interfering with its high serum concentration is expected to play a therapeutic role in these diseases.