产科抗磷脂综合征诊治现状

doi:10.12280/gjszjk.20240073

摘要/Abstract

摘要：

产科抗磷脂综合征（obstetric antiphospholipid syndrome，OAPS）是一种自身免疫性疾病，以抗磷脂抗体（antiphospholipid antibody，aPL）持续阳性和病理妊娠为主要特征，临床可表现为复发性流产、胎死宫内、胎儿生长受限、子痫前期和早产等。早期诊断及妥善管理OAPS患者可显著减少妊娠并发症的发生。目前的一线治疗方案为阿司匹林联合低分子肝素，可改善大部分患者的妊娠结局；二线治疗药物如羟氯喹、糖皮质激素等，可作为一线治疗方案的补充；新兴的治疗药物如生物制剂、他汀类药物在临床上的应用仍处于探索阶段。综述OAPS的诊断与治疗进展。

关键词: 抗磷脂综合征, 妊娠, 抗体, 抗磷脂, 诊断, 治疗, 阿司匹林, 肝素, 低分子量

Abstract:

Obstetric antiphospholipid syndrome (OAPS) is an autoimmune disease characterized by persistent positivity of antiphospholipid antibody (aPL) and pathological pregnancy, with clinical manifestations such as recurrent spontaneous abortion, fetal death, fetal growth restriction, preeclampsia, and premature delivery. Early diagnosis and appropriate management of the patients with OAPS can significantly reduce the incidence of pregnancy complications. Currently, the first-line therapeutic option is aspirin combined with low molecular weight heparin, which improves the pregnancy outcome in most patients. The second-line therapeutic medications, such as hydroxychloroquine and glucocorticoid, can be used as a complement to the first-line therapeutic option. The emerging therapeutic medications, such as biologics and statins, are still at the exploratory stage of clinical application. In this article, we review the advances in the diagnosis and treatment of OAPS.

Key words: Antiphospholipid syndrome, Pregnancy, Antibodies, antiphospholipid, Diagnosis, Therapy, Aspirin, Heparin, low-molecular-weight

李彦林, 何银芳. 产科抗磷脂综合征诊治现状[J]. 国际生殖健康/计划生育杂志, 2024, 43(3): 254-259.

LI Yan-lin, HE Yin-fang. Progress in the Diagnosis and Treatment of Obstetric Antiphospholipid Syndrome[J]. Journal of International Reproductive Health/Family Planning, 2024, 43(3): 254-259.

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