抗心磷脂抗体阳性产妇胎盘的病理观察.doc

抗心磷脂抗体阳性产妇胎盘的病理观察
中华妇产科杂志1998年第2期第33卷论著
作者：黄曙光吴桂芳王兆平程宁范燕燕唐敏红孙达成张璐红
单位：213003江苏省常州市妇产医院病理科(黄曙光，张璐红)，实验室(吴桂芳，程宁，唐敏红，孙达成)，产科(王兆平，范燕燕)
关键词：抗体；抗磷脂；妊娠结局；胎盘；荧光免疫技术
【摘要】目的探讨抗心磷脂抗体(anticardiolipinantibody,ACA)阳性产妇与不良妊娠的关系。方法选ACA阳性产妇胎盘16例(不良妊娠及正常妊娠结果各8例)为研究组。ACA阴性产妇胎盘8例为对照组。用免疫荧光法标记。结果免疫荧光显示研究组胎盘的滋养细胞胞浆和绒毛血管壁出现免疫复合物沉积。IgA表现为线条状，IgG、IgM、C3和C4表现为线条状，颗粒状和块状。对照组免疫球蛋白均呈阴性反应，C4呈小灶性阳性反应。同期分娩的IUGR病例中，ACA阳性发生率为19.30%(22/114)；ACA阳性产妇中IUGR发生率为15.28%(22/144)。IUGR合并重度妊高征3例，早产2例。5例新生儿血清ACAIgG阳性。结论ACA阳性产妇的不良妊娠后果与自身免疫系统功能异常有关。胎盘部位的免疫性损伤可影响胎盘功能。
Immuno-PathomorphologicalStudyofPlacentawithAnticardiophospholipidAntibodyPositiveHuangShuguang,WuGuifang,WangZhaoping,etal.ChangzhouObstetricsandGynecologyHospital,Changzhou213003
【Abstract】ObjectiveToinvestigatetherelationshipbetweentheanticardiophospholipidantibody(ACA)-positivecasesandthepoorpregnancyoutcomesbyobservingtheimmuno-pathomorphologyoftheplacenta.Methods16casesofACA-positiveplacenta(8normaland8poorpregnancyoutcomes)werecollectedasthestudiedgroup,and8casesofACA-negativeplacentasservedasthecontrolledgroup,andimmunofluorescencetechnique(IFT)wasused.ResultsInthestudiedgroup,thedepositsofimmuno-complexwerefoundinthecytoplasmoftrophoblastandonthewallsofvillousbloodvessels.IgAmanifestedasfiliform,andIgG,IgM,C3andC4appearedasfiliform,granularandtubercularaswell.Incontrast,alltheimmunoglobulinsdisplayednegativereactioninthecontrolledgroup,andC4demonstratedsomesmallfocalpositivereaction.ThefrequencyofACA-positiveinIUGRcaseswere19.30%(22/144),andoftheIUGRinalltheACA-positivepregnantwomenwas15.28%(22/144).Therewere3casesofIUGRcomplicatedbyseverepregnancyinducedhypertension,2casesofprematurityand5newbornswithserumACAIgGpositive.ConclusionThepoorpregnancyoutcomeinACA-positivewomenisrelatedtothedysfunctionofautoimmuno-system,andACA-positivemaybeoneofthecausesofIUGR.Theimmuno-injuryoccurredintheplacentamayaffectthenormalfunctionofplacenta.Maternalantibodymaybetransmittedtothefetus,anditssignificanceneedsfurtherstudy.
【Keywords】Antibodies,antiphosphol