作者：Tabacco S ,et al.
翻译: 河北保定解放军82集团军医院 刘振华
译者简介：刘振华，硕士研究生，河北保定解放军82集团军医院（原解放军252医院）中医康复科主治医师，现任中国中医药研究促进会青年医师分会委员，保定市风湿病学专业委员会委员。2019年于北医三院进修，师从刘湘源教授，系统学习免疫性不良妊娠的诊断及治疗。
【摘要】
在过去的二十年中，使用低分子量肝素和低剂量阿司匹林的常规治疗，抗磷脂综合征妇女的妊娠预后显著改善。然而，尽管如此，10-15%的抗磷脂综合征患者仍然经历了妊娠损失。
确定预测并发症的危险因素，已经进行了几项研究。血栓形成已被普遍认为是妊娠发病的关键机制。然而，单纯的血栓形成状态并不能解释导致妊娠失败的所有机制。
事实上，新的证据表明补体途径在抗磷脂综合征的临床事件中起着重要的介导作用。然而，补体介导抗磷脂综合征并发症的确切机制尚不清楚。多项的研究表明，低补体水平（C3和C4）与抗磷脂综合征妇女的不良妊娠结局相关。
低补体血症可作为不良妊娠结局的早期预测指标，如有必要，在妊娠初期可作为常规治疗的补充治疗。然而，我们需要进一步研究以便更好地了解低补体水平对抗磷脂综合征妊娠结局的影响。
附原文
ABSTRACT: Prognosis of pregnancies in women with antiphospholipid syndrome has dramatically improved over the past two decades using conventional treatment with low molecular weight heparin and low-dose aspirin. However, despite this regimen, 10-15% of antiphospholipid syndrome patients experience pregnancy losses. Several studies have been performed in order to identify risk factors predictive of complications. Thrombosis has been generally accepted as the key pathogenetic mechanism underlying pregnancy morbidity. However, the thrombogenic state alone is not able to explain all the different mechanisms leading to pregnancy failure. In fact, emerging evidence shows that complement pathway could play an important role in mediating clinical events in antiphospholipid syndrome.
However, the exact mechanism through which complement mediates antiphospholipid syndrome complications remains unknown. Low complement levels (C3 and C4) are associated with poor pregnancy outcome in women with antiphospholipid syndrome in different studies. Hypocomplementemia could be indicated as an early predictor of adverse pregnancy outcome, available at the beginning of pregnancy for starting, if necessary, additional treatment to conventional therapy. However, future studies need to better understand the impact of low complement level >
引自
Tabacco S; Giannini A; Garufi C; Botta A; Salvi S; Del Sordo G; Benedetti Panici P; Lanzone A; De Carolis S. Complementemia in pregnancies with antiphospholipid syndrome.
. Lupus.2019;DOI: ；1503-1509.
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