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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-GPⅠ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-GPⅠ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β2GPⅠ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。
Objective To investigate the expression and clinical significance of serum anti-cardiolipin antibody (ACA) and anti-β2-GP Ⅰ antibody in patients with systemic lupus erythematosus (SLE). Methods The serum levels of ACA and β2-GPⅠ in 84 cases of SLE (SLE group), 50 cases of other non-SLE connective tissue diseases (non-SLE group) and 30 healthy subjects (healthy control group) were detected by ELISA. The clinical symptoms, laboratory parameters, echocardiography, double hip MRI and SLE disease activity index (SLEDAI) scores of patients in SLE group were analyzed retrospectively. Results The positive rates of ACA and anti-β2-GPⅠ antibody in SLE group were 61.90% and 27.38%, respectively, which were positively correlated with SLEDAI score (P <0.05). ACA positive and thrombosis, abnormal pregnancy, thrombocytopenia, proteinuria, hypertension, Raynaud’s phenomenon and avascular necrosis; anti-β2-GP Ⅰ antibody positive and thrombosis, abnormal pregnancy, hypertension, Raynaud’s phenomenon and pulmonary hypertension related. Conclusions ACA and anti-β2GPⅠ antibody play an important role in the pathogenesis and progression of SLE. It has important clinical significance in the diagnosis of SLE, the evaluation of the severity of the disease, the prognosis and the observation of the curative effect.