系统性红斑狼疮患儿血清抗β_2-糖蛋白Ⅰ抗体亚型与抗心磷脂抗体对比性分析

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目的 通过分析伴有继发性抗磷脂综合征和无抗磷脂综合征的儿童系统性红斑狼疮 (SLE)血清的抗 β2 糖蛋白I( β2 GPⅠ )抗体亚型 ,对其抗心磷脂 (aCL)抗体亚型及抗磷脂综合征的临床症状进行评价。方法 对 2 0 0 0年 1月至 2 0 0 3年 9月北京儿童医院收治的SLE患儿 110例 ,采用酶联免疫吸附技术进行抗 β2 GPⅠ抗体和抗aCL抗体的测定 ,用酶标记特异性抗体进行各亚型的分析。采用脑磷脂 白陶土法进行狼疮抗凝集物的测定。同时对 6例伴有继发性抗磷脂综合征的SLE患儿进行了动态监测。结果  110例SLE患儿中有 2 2 7%( 2 5 / 110 )抗β2 GPⅠ抗体升高 ,其中伴有继发性抗磷脂综合征的SLE组中占 5 7 1% ( 2 4 / 4 2 ) ;无继发性抗磷脂综合征的SLE组中仅占 1 5 % ( 1/ 6 8) ,两组差异具有非常显著性意义。 110例SLE患儿中有 5 1 8% ( 5 7/ 110 )抗aCL抗体升高 ,其中 ,在伴有继发性抗磷脂综合征患儿中占 6 6 7% ( 2 8/ 4 2 ) ;无继发性抗aCL抗体的SLE者中占 4 2 7% ( 2 9/ 6 8) ,两组相比 ,差异具有显著性意义。在类风湿性关节炎对照组中 ,有 32 1%的患儿抗aCL抗体呈阳性但均为低阳性。SLE患儿组与正常对照组、类风湿性关节炎对照组相比 ,差异均具有显著性意义。 6例在动态观察中抗体亚型和水平随疾病 OBJECTIVE: To analyze the anticardiolipin (aCL) anti-β2 glycoprotein I (β2 GPⅠ) antibody subtype in children with systemic lupus erythematosus (SLE) accompanied by secondary antiphospholipid syndrome and without antiphospholipid syndrome, Antibody subtype and anti-phospholipid syndrome clinical symptoms were evaluated. Methods 110 children with SLE admitted to Beijing Children’s Hospital from January 2000 to September 2003 were enrolled in this study. The anti-β2 GP Ⅰ antibody and anti-aCL antibody were detected by enzyme linked immunosorbent assay (ELISA) Antibodies were analyzed for each subtype. Determination of lupus anticoagulant using cephalosporin clay method. At the same time, 6 cases of SLE with secondary antiphospholipid syndrome were monitored dynamically. Results Twenty-two of the 110 children with SLE developed anti-β2 GPⅠ antibody, of which 51.7% (2 4/42) in the SLE group with secondary antiphospholipid syndrome ); Only 15% (1/68) of SLE patients without secondary antiphospholipid syndrome, the difference between the two groups has a very significant significance. Among the 110 children with SLE, 51.8% (57/110) showed increased anti-aCL antibody, of which 66.7% (28/42) in children with secondary antiphospholipid syndrome ; There was 42.7% (29/68) in SLE without secondary anti-aCL antibody. There was significant difference between the two groups. In the rheumatoid arthritis control group, 32.1% of children were positive for anti-aCL antibodies but both were low positive. SLE children with normal control group and rheumatoid arthritis control group, the differences were significant. Six cases were dynamically observed for antibody subtype and level with disease
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