系统性红斑狼疮患者抗心磷脂抗体与抗β2糖蛋白Ⅰ抗体的表达及意义

摘要

Objective To explore the expression and significance of anticardiolipin antibody (ACA) and anti-β2 glycoprotein Ⅰ (anti-β2GP Ⅰ ) antibody in the patients with systemic lupus erythematosus(SLE). Methods Serum ACA and anti-β2GP Ⅰ of 84 SLE patients, 30 patients with rheumatoid arthritis(RA) ,20 patients with Sjogren syndrome (SS) and 30 healthy individuals were detected by ELISA. The laboratory and clinical features (thrombosis, fetal loss, etc), the data of echocardiogram and MRI were analyzed retrospectively. Results The positive rates of ACA and anti-β2GP Ⅰ were 61. 90% and 27. 38%, respectively, which were positively correlated to SLEDAI scores. The ACA positive was related with thrombus, abnormal pregnancy, thrombocytopenia, proteinuria, hypertension,Raynaud s phenomenon and avascular necrosis of femoral head. The anti-β2GP I positive was related to thrombus, abnormal pregnancy, hypertension, Raynaud s phenomenon and pulmonary hypertension. Conclusion ACA and anti-β2GP Ⅰ play an important role in developing of SLE and disease progress. The detection of ACA and anti-β2GP Ⅰ has important significance in diagnosis, evaluation,monitoring and treatment of SLE.%目的 探讨系统性红斑狼疮(SLE)患者血清抗心磷脂抗体(ACA)及抗β2糖蛋白Ⅰ抗体(β2-GPⅠ)的表达及临床意义.方法 采用ELISA法检测84例SLE(SLE组)、50例非SLE的其他结缔组织病(非SLE组)及30例健康体检者(健康对照组)的血清ACA及β2-GP Ⅰ的表达,同时对SLE组患者临床症状、实验室指标、超声心动图、双髋关节MRI及SLE疾病活动指数(SLEDAI)积分进行回顾性分析.结果 SLE组ACA、抗β2-GPⅠ抗体阳性率分别为61.90％和27.38％,与SLEDAI积分呈正相关(P＜0.05).ACA阳性与血栓、异常妊娠、血小板减少、蛋白尿、高血压、雷诺氏现象及股骨头缺血性坏死有关;抗β2-GP Ⅰ抗体阳性与血栓、异常妊娠、高血压、雷诺氏现象及肺动脉高压有关.结论 ACA及抗β2GP Ⅰ抗体在SLE的发病及病情发展起了重要的作用,对SLE的诊断、病情严重程度的评价、判断预后及疗效观察等均有重要的临床意义.