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(anticardiolipin antibody, 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ACA IgG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-Pathomorphological Study of Placenta with Anticardiophospholipid Antibody Positive　Huang Shuguang, Wu Guifang, Wang Zhaoping, et al. Changzhou Obstetrics and Gynecology Hospital, Changzhou 213003 　　【Abstract】　Objective　To investigate the relationship between the anticardiophospholipid antibody (ACA)-positive cases and the poor pregnancy outcomes by observing the immuno-pathomorphology of the placenta.Methods 16 cases of ACA-positive placenta (8 normal and 8 poor pregnancy outcomes) were collected as the studied group, and 8 cases of ACA-negative placentas served as the controlled group, and immunofluorescence technique (IFT) was used.Results In the studied group, the deposits of immuno-complex were found in the cytoplasm of trophoblast and on the walls of villous blood vessels. IgA manifested as filiform, and IgG, IgM, C3 and C4 appeared as filiform, granular and tubercular as well. In contrast, all the immuno globulins displayed negative reaction in the controlled group, and C4 demonstrated some small focal positive reaction. The frequency of ACA-positive in IUGR cases were 19.30% (22/144), and of the IUGR in all the ACA-positive pregnant women was 15.28%(22/144). There were 3 cases of IUGR complicated by severe pregnancy induced hypertension, 2 cases of prematurity and 5 newborns with serum ACA IgG positive.Conclusion The poor pregnancy outcome in ACA-positive women is related to the dysfunction of autoimmuno-system,