摘要速递

题目：在一项纳入197名患有抗磷脂综合征或抗磷脂抗体携带者的女性共260例妊娠的多中心研究中，发现孕前低补体水平与不良妊娠结局相关期刊：Biomedicines发表时间：2021年6月关键词：抗磷脂抗体;抗磷脂综合征;补体;妊娠结局;怀孕

摘要翻译

在实验动物模型中，抗磷脂抗体（aPL）可诱导胎儿丢失。临床研究确实发现抗磷脂综合征（APS）患者的低补体血症与妊娠并发症相关，但这些结果并未得到一致证实。为了证实低补体水平（C3/C4）的检测是否可以被视为 APS患者和aPL携带者发生不良妊娠结局（APO）的危险因素，我们进行了一项多中心研究，包括来自11个意大利和1个俄罗斯中心的503例妊娠，其中197名患有抗磷脂综合征或抗磷脂抗体携带者的女性的260例妊娠数据可用。结果显示，相比于没有出现妊娠并发症的女性，伴有妊娠并发症的这部分患者补体水平普遍更低（p=0.0009，p＜0.0001）；在孕前补体（C3/C4）水平较低的妊娠中，流产的发生率显著升高（p=0.008）。同时针对三重aPL阳性患者的亚组分析发现，孕前低C3和/或C4水平与妊娠丢失率增加相关（p=0.05）。研究结果证实，怀孕前补体水平降低与APO风险增加有关。亚组分析中只见于具有三重 aPL 阳性的女性，单阳性或双阳性并未显示这种趋势。本研究认为，补体水平的检测价格便宜且易于测量，因此它们可以作为识别患者流产风险增加的有用辅助工具。原版英文摘要Antiphospholipid antibodies (aPL) can induce fetal loss in experimental animal models. Human studies did find hypocomplementemia associated with pregnancy complications in patients with antiphospholipid syndrome (APS), but these results are not unanimously confirmed. To investigate if the detection of low C3/C4 could be considered a risk factor for adverse pregnancy outcomes (APO) in APS and aPL carriers' pregnancies we performed a multicenter study including 503 pregnancies from 11 Italian and 1 Russian centers. Data in women with APS and asymptomatic carriers with persistently positive aPL and preconception complement levels were available for 260 pregnancies. In pregnancies with low preconception C3/C4, a significantly higher prevalence of pregnancy losses was observed (p = 0.008). A subgroup analysis focusing on triple aPL-positive patients found that preconception low C3 and/or C4 levels were associated with an increased rate of pregnancy loss (p = 0.05). Our findings confirm that decreased complement levels before pregnancy are associated with increased risk of APO. This has been seen only in women with triple aPL positivity, indeed single or double positivity does not show this trend. Complement levels are cheap and easy to be measured therefore they could represent a useful aid to identify patients at increased risk of pregnancy loss.参考文献：Nalli C, Lini D, Andreoli L, et al. Low Preconception Complement Levels Are Associated with Adverse Pregnancy Outcomes in a Multicenter Study of 260 Pregnancies in 197 Women with Antiphospholipid Syndrome or Carriers of Antiphospholipid Antibodies. Biomedicines. 2021 Jun 11;9(6):671.作者 | 陈雨欣版面 | 黄伊宁审核 | 张建瑜医脉通是专业的在线医生平台，“感知世界医学脉搏，助力中国临床决策”是平台的使命。医脉通旗下拥有「临床指南」「用药参考」「医学文献王」「医知源」「e研通」「e脉播」等系列产品，全面满足医学工作者临床决策、获取新知及提升科研效率等方面的需求。