Correlation analysis of platelet antibodies with adverse pregnancy outcome history and number of pregnancies
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摘要: 目的 通过分析孕妇妊娠期的血小板抗体检测结果，探讨血小板抗体与不良孕产史以及妊娠次数的关系。方法 选取2021年1月—2022年10月在医院产科分娩的484例孕妇，孕妇妊娠期均接受血小板抗体检测，分析其临床资料，根据不良孕产史情况分为有不良孕产史组(84例)及无不良孕产史组(400例)，比较2组血小板抗体阳性率；根据妊娠次数分为甲乙丙3组：甲组(1次)，乙组(2~3次)，丙组(>3次)，比较其血小板抗体阳性率；比较血小板抗体阳性组(42例)和抗体阴性组(442例)的分娩方式。结果 有不良孕产史组和无不良孕产史组血小板抗体阳性率分别是14.3%和7.5%，差异有统计学意义(P < 0.05)；妊娠次数不同，3组血小板抗体阳性率(甲组：6.3%；乙组：7.5%；丙组：15.5%)比较差异有统计学意义(P < 0.05)；组间比较，妊娠次数和血小板抗体阳性有线性趋势(P < 0.05)。结论 有不良孕产史孕妇血小板抗体阳性率增高；随着妊娠次数增加，孕妇血小板抗体阳性率升高；将血小板抗体检测作为妊娠期的产检项目可以更好地监测孕妇和胎儿的健康状态，可以有效地探讨流产的原因、预测及早期预防胎儿和新生儿同种免疫性血小板减少症。Abstract: Objective To analyze the testing results of platelet antibody in pregnant women during pregnancy, so as to explore the relationship between platelet antibody and adverse pregnancy outcome history and the number of pregnancies.Methods A total of 484 pregnant women who delivered in the obstetrics department of our hospital from January 2021 to October 2022 were selected. All of them received platelet antibody detection during pregnancy, and their clinical data were analyzed. According to the outcome of adverse pregnancy, they were divided into the group with adverse pregnancy history(84 cases) and the group without adverse pregnancy history(400 cases), the positive rate of platelet antibody was compared between the two groups. Cases were divided into three groups according to the number of pregnancies: group A(1 time), group B(2-3 times), and group C(>3 times), and the positive rates of platelet antibody were compared; The mode of delivery was compared between the platelet antibody positive group(42 cases) and the platelet antibody negative group(442 cases).Results The positive rate of platelet antibody in groups with and without adverse pregnancy outcome was 14.3% vs 7.5%, showing statistical significance(P < 0.05). The positive rate of platelet antibody of Group A, B and C was 6.3%, 7.5% and 15.5% respectively, with the significant differences(P < 0.05). The statistical analysis of inter-group χ2 test demonstrated a linear trend between the number of pregnancies and platelet antibodies yielding(χ2=5.54, P < 0.05).Conclusion Platelet antibody positivity rate increased in pregnant women with adverse pregnancy history. As the number of pregnancies increased, the positive rate of platelet antibodies in pregnant women increased. Platelet antibody testing as a maternity test during pregnancy could better monitor the health status of pregnant women and fetuses, and could be effective in exploring the causes of miscarriage, prediction and early prevention of fetal and neonatal isoimmune thrombocytopenia.
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Key words:
- platelet antibody /
- adverse pregnancy outcome /
- number of pregnancies
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表 1 有无不良孕产史孕妇相关指标比较
不良孕产史 合计/例 年龄/岁 孕周/周 血小板计数/(×109/L) 甲组/例 乙组/例 丙组/例 有 84 32.96±4.04 38.5 203.46±48.23 0 39 45 无 400 32.77±4.06 39.0 199.67±49.11 160 188 52 
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[1] 侯巧芳, 廖世秀. 不良孕产史的再生育咨询[J]. 实用妇产科杂志, 2023, 39(3): 164-167.
[2] 邹甜甜, 费安兴, 魏莉平, 等. 染色体平衡易位致不良孕产史3例报道[J]. 检验医学, 2022, 37(9): 894-896. https://www.cnki.com.cn/Article/CJFDTOTAL-SHYY202209021.htm
[3] 王彩莲, 张军. 孕期血小板抗原抗体检测的研究进展[J]. 中华全科医学, 2018, 16(8): 1355-1359. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201808037.htm
[4] 冯红梅, 蔡祥胜, 杨兆收, 等. 血小板抗体产生的影响因素分析[J]. 广东药科大学学报, 2019, 35(5): 674-678. https://www.cnki.com.cn/Article/CJFDTOTAL-GDYX201905020.htm
[5] 苏金花, 陈宇锋, 刘飒爽. 血小板抗体检测在复发性流产及新生儿免疫性血小板减少症中的诊断价值探讨[J]. 中国实用医药, 2021, 16(10): 97-99.
[6] 邱立娟, 付晓艳, 郭凯, 等. 60例血小板抗体初筛强阳性患儿的抗体效价分析[J]. 临床输血与检验, 2021, 23(6): 704-707.
[7] 林燕, 聂宇波, 徐静, 等. 固相凝集法血小板抗体检测与早期流产相关性探讨[J]. 中国生化药物杂志, 2016, 36(10): 146-148. https://www.cnki.com.cn/Article/CJFDTOTAL-SHYW201610043.htm
[8] 陆乐, 李平, 刘婷婷, 等. 不同性别、临床科室患者血小板抗体筛查结果分析[J]. 国际检验医学杂志, 2021, 42(3): 263-265, 269. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSQ202103003.htm
[9] 马德冉, 赵莉, 田野, 等. 6例新生儿同种免疫性血小板减少症临床资料回顾分析[J]. 中国输血杂志, 2020, 33(10): 1026-1028.
[10] 陈丽, 周浩, 郭博, 等. 孕妇孕期血小板抗体检测的影响因素分析[J]. 中国输血杂志, 2019, 32(6): 575-577. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO201906021.htm
[11] 魏亚明, 桂嵘, 王秋实, 等. 血小板抗体检测专家共识[J]. 临床输血与检验, 2020, 22(1): 1-5.
[12] 周婕, 徐敏, 黄琳琳, 等. 血小板特异性自身抗体在免疫性血小板减少症患者的临床特征和预后评估中的作用[J]. 临床血液学杂志, 2022, 35(7): 469-473, 478. https://lcxy.whuhzzs.com/article/doi/10.13201/j.issn.1004-2806.2022.07.004
[13] 汤洁, 赵莹莹, 魏威, 等. 血小板血型抗体与妊娠次数及复发性流产关系的研究[J]. 沈阳医学院学报, 2016, 18(6): 445-446, 450. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYX201606017.htm
[14] 周超, 徐军, 马继华, 等. 新生儿同种免疫性血小板减少症血清学诊断结果和临床资料分析[J]. 中国实验血液学杂志, 2022, 30(4): 1219-1223.
[15] 代凤, 王锐, 胡梦思, 等. HLA抗体的产生与孕妇妊娠次数关系的研究[J]. 中国输血杂志, 2017, 30(7): 674-676. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO201707008.htm
[16] 郝欣欣, 邓晶, 丛桂敏, 等. 胎儿/新生儿同种免疫性血小板减少症的诊断——附1例并文献复习[J]. 中国输血杂志, 2020, 33(11): 1167-1172. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO202011017.htm
[17] 谢仁伟, 王明泉, 李丽群, 等. 孕晚期孕妇2038例血小板抗体筛查分析[J]. 福建医药杂志, 2016, 38(2): 98-99.
[18] 谢一唯, 王莹, 李育, 等. 血小板抗体对早期流产和新生儿同种免疫性血小板减少性紫癜的预测价值[J]. 浙江医学, 2019, 41(6): 533-536.
[19] Kjeldsen-Kragh J, Bengtsson J. Fetal and neonatal alloimmune thrombocytopenia-new prospects for fetal risk assessment of HPA-1a-negative pregnant women[J]. Transfus Med Rev, 2020, 34(4): 270-276.
[20] 吴远军, 隗伏冰, 张咏梅, 等. 胎儿及新生儿同种免疫性血小板减少症研究进展[J]. 中华围产医学杂志, 2020, (5): 348-353.
[21] 张文丽, 宗朋, 周鸿晨, 等. 孕妇孕期血小板抗体筛查的影响因素分析[J]. 中国输血杂志, 2021, 34(1): 34-36.
[22] Mark KF. 美国血库协会技术手册[M]. 北京: 人民卫生出版社, 2020: 409-410.
[23] Yougbaré I, Lang SA, Yang H, et al. Maternal anti-platelet β3 integrins impair angiogenesis and cause intracranial hemorrhage[J]. J Clin Invest, 2015, 125(4): 1545-1556.
[24] Winkelhorst D, Oostweegel M, Porcelijn L, et al. Treatment and outcomes of fetal/neonatal alloimmune thrombocytopenia: a nationwide cohort study in newly detected cases[J]. Brit J Haematol, 2019, 184(6): 1026-1029.
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