北京大学学报（医学版）2023，Vol.55Issue(6)：1053-1057,5.DOI:10.19723/j.issn.1671-167X.2023.06.015
合并胎儿心脏病变的抗SSA抗体阳性孕妇的临床及实验室特征
Clinical characteristics of fetal cardiac disease in patients with anti-SSA antibody positive
摘要
Abstract
Objective:To investigate the clinical manifestations and laboratory indicators of anti-Sjögren's-syndrome-related antigen A(SSA)antibody associated fetal cardiac disease.Methods:Preg-nant women hospitalized at Peking University People's Hospital from January 2013 to July 2023 were in-cluded.Eleven patients with anti-SSA antibody positive were eventually diagnosed with fetal cardiac di-sease.And patients with anti-SSA antibody positive without fetal cardiac disease were selected as con-trols.Clinical manifestations,laboratory indications and drug usage were compared between the two groups.Results:Among these 11 patients,congenital heart block was confirmed in seven,which was the most common manifestations of fetal cardiac malformation.The proportion of the patients diagnosed with autoimmune disease before pregnancy in fetal cardiac malformation group was significantly lower than that in the control group(P=0.032),while most of the patients in the fetal cardiac malformation group re-ceived immune-related examinations for the first time because of this time's fetal cardiac diagnosis.While most of the patients in the control group received routine examinations because of autoimmune diseases diagnosed before pregnancy.During pregnancy,the white blood cell level[(9.29±2.58)× 109/L vs.(7.10±1.90 × 109/L,t=3.052,P=0.004],erythrocyte sedimentation rate[(49.50(48.00,51.00)mm/h vs.23.00(15.00,30.25)mm/h,Z=-2.251,P=0.024],IgA level[3.46(2.30,5.06)g/L vs.2.13(1.77,2.77)g/L,Z=-2.181,P=0.029],and antinuclear antibody(ANA)titers[1∶320(1∶160,1∶320)vs.1∶80(1∶40,1∶160),Z=-3.022,P=0.003]were significantly higher in fetal cardiac malformation group than in the control group.The proportion of positive anti-SSB antibody during pregnancy did not show a statistically significant difference between the two groups(37.5％vs.7.7％,P=0.053).There was no significant difference in hydroxychloroquine dosage and initiation time between the two groups.The dosage of prednisone in the second and third trimesters was significantly higher in the cardiac malformation group than that in the control group,but there was no sig-nificant difference in the first trimester.Conclusion:Fetal cardiac disease is rare in pregnant women with anti-SSA antibody.White blood cell,erythrocyte sedimentation rate,IgA,the titer of ANA positivity were higher in the fetal heart disease group during pregnancy.Since congenital heart block is difficult to reverse,its prevention and monitoring are more important than remedial treatment.关键词
抗SSA抗体/先天性心脏缺损/心脏传导阻滞/妊娠/危险因素Key words
Anti-Sjögren's-syndrome-related antigen A antibody/Congenital heart defects/Heart block/Pregnancy/Risk factors分类
医药卫生引用本文复制引用
李宇菲,闫亚妮,靳家扬,李春,裴秋艳..合并胎儿心脏病变的抗SSA抗体阳性孕妇的临床及实验室特征[J].北京大学学报（医学版）,2023,55(6):1053-1057,5.基金项目
中华国际医学交流基金会(Z-2018-40-2101)和北京大学人民医院研究与发展基金(RD 2022-66)Supported by China lnternational Medical Foundation(Z-2018-40-2101)and Peking University People's Hospital Scientific Research Development Funds(RD 2022-66) （Z-2018-40-2101）
