akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2025.584akusherstvo-2346Research ArticleОRIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИPlasmapheresis for lowering the risks of placenta-associated complications in antiphospholipid syndromeСнижение рисков плацента-ассоциированных осложнений при антифосфолипидном синдроме с использованием плазмаферезаhttps://orcid.org/0000-0002-2754-5129КунешкоН. Ф.KuneshkoN. F.

Кунешко Нарт Фарук, к.м.н.

143003 Московская область, Одинцово, ул. Маршала Бирюзова, д. 3б

Nart F. Kuneshko, MD, PhD.

3b Marshala Biryuzova Str., Odintsovo, Moscow region 143003

https://orcid.org/0000-0002-1646-8690КимВ. В.KimV. V.

Ким Виктор Валерьевич

127006 Москва, ул. Долгоруковская, д. 4

Viktor V. Kim, MD.

4 Dolgorukovskaya Str., Moscow 127006

https://orcid.org/0009-0004-6971-8552ЛядноваЕ. М.LyadnovaE. M.

Ляднова Елизавета Михайловна

119991 Москва, ул. Трубецкая, д. 8, стр. 2

Elizaveta M. Lyadnova

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0009-0009-1209-7456МеткинаА. Р.MetkinaA. R.

Меткина Анастасия Романовна

119991 Москва, ул. Трубецкая, д. 8, стр. 2

Anastasia R. Metkina

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0009-0008-0694-5984ВелиеваМ. Н.VelievaM. N.

Велиева Мадина Намиг кызы

119991 Москва, ул. Трубецкая, д. 8, стр. 2

Madina N. Velieva

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0003-2136-1641ЛазарчукА. В.LazarchukA. V.

Арина Владимировна Лазарчук

119991 Москва, ул. Трубецкая, д. 8, стр. 2

Arina V. Lazarchuk, MD. 

8 bldg. 2, Trubetskaya Str., Moscow 119991

arina.lazarchuk@mail.ruhttps://orcid.org/0000-0001-8404-1042БицадзеВ. О.BitsadzeV. O.

Бицадзе Виктория Омаровна, д.м.н., проф., профессор РАН

Scopus Author ID: 6506003478

WoS ResearcherID: F-8409-2017

119991 Москва, ул. Трубецкая, д. 8, стр. 2

Victoria O. Bitsadze, MD, Dr Sci Med, Prof., Professor of RAS

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0002-3628-0804ТретьяковаМ. В.TretyakovaM. V.

Третьякова Мария Владимировна, к.м.н.

119991 Москва, ул. Трубецкая, д. 8, стр. 2

Maria V. Tretyakova, MD, PhD.

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0002-3367-9844БлиновД. В.BlinovD. V.

Блинов Дмитрий Владиславович, к.м.н.

Scopus Author ID: 6701744871

WoS ResearcherID: E-8906-2017

101000 Москва, Лялин переулок, д. 11–13/1; 123056 Москва, 2-я Брестская ул., д. 5, с. 1–1а; 141551 Московская область, деревня Голубое, Родниковая ул., стр. 6, к. 1

Dmitry V. Blinov, MD, PhD, MBA.

11–13/1 Lyalin Pereulok, Moscow 101000; 5 bldg. 1–1a, 2-ya Brestskaya Str., Moscow 123056; 6 bldg. 1, Rodnikovaya Str., Goluboe Village, Moscow region 141551

ГБУЗ МО «Одинцовская областная больница»РоссияOdintsovo Regional HospitalRussian FederationФГБУ ВО «Российский университет медицины» Министерства здравоохранения Российской ФедерацииРоссияRussian University of Medicine, Ministry of Health of the Russian FederationRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov UniversityRussian FederationИнститут Превентивной и Социальной Медицины; АНО ДПО «Московский медико-социальный институт имени Ф.П. Гааза»; ФГБУ «Федеральный научно-клинический центр медицинской реабилитации и курортологии Федерального медико-биологического агентства»РоссияInstitute for Preventive and Social Medicine; Moscow Haass Medical – Social Institute; Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology, Federal Medical-Biological AgencyRussian Federation2025060320251914758Copyright © Kuneshko N.F., Kim V.V., Lyadnova E.M., Metkina A.R., Velieva M.N., Lazarchuk A.V., Bitsadze V.O., Tretyakova M.V., Blinov D.V., 20252025Кунешко Н.Ф., Ким В.В., Ляднова Е.М., Меткина А.Р., Велиева М.Н., Лазарчук А.В., Бицадзе В.О., Третьякова М.В., Блинов Д.В.Kuneshko N.F., Kim V.V., Lyadnova E.M., Metkina A.R., Velieva M.N., Lazarchuk A.V., Bitsadze V.O., Tretyakova M.V., Blinov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/2346Aim

Aim: to study plasmapheresis (PP) effect on antiphospholipid syndrome (APS) treatment during preconception preparation and pregnancy.

Materials and Methods

Materials and Methods. A single-center, prospective, randomized, uncontrolled study was conducted. A total of 137 women aged 22 to 32 years diagnosed with APS-related habitual miscarriage were examined. The patients were stratified as follows: main group consisted of 73 patients underwent a PF course (7 procedures at preconception preparation stage); comparison group – 64 patients not underwent efferent therapy. Antiphospholipid antibodies (APA) circulation was determined by solid-phase immunofluorescence. PР was performed using an intermittent technique. The laboratory study included assessing titers of lupus anticoagulant (LA), anti-cardiolipin antibodies (aCL), anti-β2-glycoprotein 1 antibodies (anti-β2-GP1) and anti-annexin V antibodies (anti-ANX). Antibody titers were measured before and after pregravid preparation.

Results

Results. After PР, anti-β2-GР1 titers decreased by 66.6 % (p = 0.00001) in main group. In patients who underwent standard therapy without PР, no significant changes in circulation level of anti-β2-GР1 were noted. LA frequency in main and comparison group decreased by 57.3 % (p = 0.042) and 10.9 % (p = 0.69), respectively.

Conclusion

Conclusion. The frequency of detecting elevated AРA levels in women after a course of efferent therapy decreased significantly, whereas standard therapy showed no such effects. PР as part of complex therapy is more appropriate for achieving maximum effect.

Цель

Цель: изучить влияние плазмафереза (ПФ) на лечение антифосфолипидного синдрома (АФС) во время прегравидарной подготовки и беременности.

Материалы и методы

Материалы и методы. Проведено одноцентровое проспективное сравнительное неконтролируемое исследование. Обследовано 137 женщин в возрасте от 22 до 32 лет с диагнозом привычный выкидыш на фоне АФС. Основную группу составили 73 пациентки, которым на этапе прегравидарной подготовки был проведен курс ПФ, состоявший из 7 процедур; в группу сравнения вошли 64 пациентки, которым эфферентную терапию не проводили. Циркуляцию антифосфолипидных антител (АФА) определяли методом твердофазной иммунофлуоресценции. ПФ выполняли по прерывистой методике. В лабораторное исследование входило определение титров волчаночного антикоагулянта (ВА), антител к кардиолипину (англ. anti-cardiolipin antibodies, aCL), антител к β2-гликопротеину 1 (англ. anti-β2-glycoprotein 1 antibodies, anti-β2-GР1) и антител к аннексину V (англ. anti-annexin V antibodies, anti-ANX). Титры антител измеряли до и после проведения прегравидарной подготовки.

Результаты

Результаты. После проведения ПФ было обнаружено снижение титров anti-β2-GР1 у пациенток основной группы на 66,6 % (р = 0,00001). У пациенток, которым была проведена стандартная терапия без применения ПФ, статистически значимых изменений по циркуляции anti-β2-GР1 отмечено не было. Частота выявления ВА в основной группе снизилась на 57,3 % (р = 0,042), в группе сравнения – на 10,9 % (р = 0,69).

Заключение

Заключение. Частота выявления повышенного содержания АФА у женщин после проведения курса эфферентной терапии значительно снизилась, в то время как стандартная терапия не приводила к существенным положительным изменениям по данным показателям. Использование ПФ для достижения максимального эффекта целесообразнее в составе комплексной терапии.

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The authors declare that there are no conflicts of interest present.