CAJ | 학술논문

目的：对生殖免疫自身抗体检测在妇科不孕不育诊断中的临床价值进行评价与探讨。方法选取548例2011年8月～2012年7月在我院接受治疗的不孕不育患者，通过ELISA（酶联免疫吸附测定）对患者ACAb(抗心磷脂抗体)、AsAb(血清抗精子抗体)、TAAb（抗滋养层抗体）、EmAb(抗子宫内膜抗体)、AhAb(抗绒毛膜促性腺激素抗体)、ZPAb(抗透明带抗体)以及AOAb(抗卵巢抗体)等免疫生殖抗体进行测定。结果在AsAb、EmAb阳性患者中，自然流产组与原发不孕组进行比较，差异有统计学意义（P＜0.05）；在EmAb患者阳性中，对原发不孕组和继发不孕组进行比较，差异有统计学意义（P＜0.05）；在ACAb患者阳性中，阳性率最高的是继发不孕组,原发不孕组、自然流产组分别对比于继发不孕组，差异有统计学意义（P＜0.05）；AOAb患者阳性中，原发不孕组与自然流产组、继发不孕组进行对比，差异有统计学意义（P＜0.05）；TAAb与ZPAb患者阳性中，自然流产组、原发不孕组以及继发不孕组相比，差异有统计学意义（P＜0.05），AhAb患者阳性中，自然流产组、继发不孕组和原发不孕组相比，差异有统计学意义（P＜0.05）。548例患者中，抗体阳性患者所占比例为75.91%，而且7项中存在1项为阳性的患者所占比例为57.93%，存在2项的比例为31.92%，存在3项以上的比例为10.07%。结论在临床诊断女性不孕不育的措施中，对其进行生殖免疫自身抗体检测是非常有必要，值得临床应用与推广。
목적：대생식면역자신항체검측재부과불잉불육진단중적림상개치진행평개여탐토。방법선취548례2011년8월～2012년7월재아원접수치료적불잉불육환자，통과ELISA（매련면역흡부측정）대환자ACAb(항심린지항체)、AsAb(혈청항정자항체)、TAAb（항자양층항체）、EmAb(항자궁내막항체)、AhAb(항융모막촉성선격소항체)、ZPAb(항투명대항체)이급AOAb(항란소항체)등면역생식항체진행측정。결과재AsAb、EmAb양성환자중，자연유산조여원발불잉조진행비교，차이유통계학의의（P＜0.05）；재EmAb환자양성중，대원발불잉조화계발불잉조진행비교，차이유통계학의의（P＜0.05）；재ACAb환자양성중，양성솔최고적시계발불잉조,원발불잉조、자연유산조분별대비우계발불잉조，차이유통계학의의（P＜0.05）；AOAb환자양성중，원발불잉조여자연유산조、계발불잉조진행대비，차이유통계학의의（P＜0.05）；TAAb여ZPAb환자양성중，자연유산조、원발불잉조이급계발불잉조상비，차이유통계학의의（P＜0.05），AhAb환자양성중，자연유산조、계발불잉조화원발불잉조상비，차이유통계학의의（P＜0.05）。548례환자중，항체양성환자소점비례위75.91%，이차7항중존재1항위양성적환자소점비례위57.93%，존재2항적비례위31.92%，존재3항이상적비례위10.07%。결론재림상진단녀성불잉불육적조시중，대기진행생식면역자신항체검측시비상유필요，치득림상응용여추엄。
Objective To evaluate and explore the clinical value of reproductive immune auto-antibody determination in the diagnosis of gynecology infertility. Methods 548 patients of gynecology infertility who were treated in our hospital during August 2011 to July 2012 were selected,and the patient's immune reproductive ant ibody(ACAb,AsAb,TAAb,EmAb,AhAb,ZPAb,AOAb,etc.)were detected by ELISA. Results In the positive AsAb and EmAb patients,the differences were significant between the spontaneous abortion group and primary infertility group(P < 0.05); In the positive EmAb patients,the difference was significant between the primary infertility group and secondary infertility group(P<0.05);In the positive ACAb patients,the secondary infertility group had the highest positive rate, and the difference was significant between the primary infertility group or spontaneous abortion group and the secondary infertility group(P<0.05);In the positive AOAb patients,the difference was significant between the primary infertility group and the spontaneous abortion group or secondary infertility group(P < 0.05);In the positive TAAb and ZPAb patients, the difference was significant between the spontaneous abortion group or primary infertility group and the secondary infertility group(P < 0.05);In the positive AhAb patients,the difference was significant between the spontaneous abortion group or secondary infertility group and the primary infertility group(P < 0.05);In 548 patients,the proportion of patients with positive antibodies was 75.91%, and the proportion of patients with the positive of only one item in seven items was 57.93%,that with the positive of two items was 31.92%, that with the positive of more than three items was 10.07%. Conclusion In clinical diagnosis measures of gynecology infertility,the reproductive immune auto-antibody determination is very necessary and worth to promote.