2025 年第 7 期 第 20 卷

抗核抗体和抗核抗体谱及抗磷脂抗体与不良妊娠结局的关系及用药情况分析

Analysis of the relationship between antinuclear antibody, antinuclear antibody spectrum, and antiphospholipid antibody and adverse pregnancy outcomes, as well as medication use

作者：唐之雅付萍

英文作者：Tang Zhiya Fu Ping

单位：昆明医科大学第二附属医院风湿免疫科，昆明650101

英文单位：Department of Rheumatology and Immunology the Second Affiliated Hospital of Kunming Medical University Kunming 650101 China

关键词：不良妊娠；妊娠结局；抗核抗体；抗磷脂抗体；用药情况

英文关键词：Adversepregnancy；Pregnancyoutcomes；Antinuclearantibodies；Antiphospholipidantibodies；Medicationuse

• 摘要：

• 目的 探讨抗核抗体、抗核抗体谱（ANAs）、抗磷脂抗体（aPLs）与不良妊娠结局的关系并分析用药情况。方法 回顾性收集2021年1月至2024年5月于昆明医科大学第二附属医院就诊的抗核抗体、ANAs、aPLs存在阳性的153例妊娠患者临床资料。记录妊娠结局，存在不良妊娠结局者纳入观察组（80例），其余妊娠结局良好者纳入对照组（73例）。比较2组的临床资料、抗核抗体、ANAs、aPLs及孕期用药情况，采用二元Logistic回归模型分析患者发生不良妊娠结局的危险因素。结果 2组既往妊娠丢失史、孕周、孕次以及剖宫产、新生儿入住新生儿科比例比较，差异均有统计学意义（均P＜0.05）。观察组抗核抗体、抗SSA抗体、抗心磷脂抗体、抗β2糖蛋白I抗体（aβ2GPI）及抗核抗体联合SSA阳性比例均高于对照组（均P＜0.05）。观察组孕期使用过药物比例低于对照组［75.0%（60/80）比90.4%（66/73）］（χ2=6.238，P=0.013）。二元Logistic回归分析结果显示，新生儿入住新生儿科、抗核抗体阳性、aβ2GPI阳性均为不良妊娠结局的危险因素，孕周为保护因素（均P<0.05）。结论 妊娠患者中发现抗核抗体、ANAs、aPLs异常，应早期干预，及时使用药物治疗减少不良妊娠结局的发生，保障母婴安全。

• Objective  To investigate the relationship between antinuclear antibody, antinuclear antibody spectrum (ANAs), antiphospholipid antibodies (aPLs) and adverse pregnancy outcomes, and analyze the medication use. Methods The clinical data of 153 pregnant patients with positive antinuclear antibodies, ANAs or aPLs in the Second Affiliated Hospital of Kunming Medical University from January 2021 to May 2024 were retrospectively collected. The pregnancy outcomes were recorded, and the patients with adverse pregnancy outcomes were included in the observation group (80 cases), and the rest of the patients with good pregnancy outcomes were included in the control group (73 cases). The clinical data, antinuclear antibodies, ANAs, aPLs and medication during pregnancy were compared between the two groups. The binary Logistic regression model was used to analyze the risk factors of adverse pregnancy outcomes. Results There were significant differences in the history of previous pregnancy loss, gestational age, gravidity, proportion of cesarean section and neonatal admission to the neonatal department between the two groups (all P<0.05). The positive rates of antinuclear antibody, anti-SSA antibody, anticardiolipin antibody, anti-β2 glycoprotein I antibody (aβ2GPI) and antinuclear antibody combined with SSA in the observation group were higher than those in the control group (all P<0.05). The proportion of drugs used during pregnancy in the observation group was lower than that in the control group ［75.0%(60/80) vs 90.4%(66/73)］(χ2=6.238, P=0.013). Binary Logistic regression analysis showed that neonatal admission to the neonatal department, positive antinuclear antibody and positive aβ2GPI were risk factors for adverse pregnancy outcomes, and gestational age was a protective factor （all P<0.05）. Conclusion Abnormal antinuclear antibodies, ANAs and aPLs are found in pregnant patients. Early intervention and timely drug treatment should be used to reduce the occurrence of adverse pregnancy outcomes and ensure the safety of mother and child.