抗心磷脂抗体和免疫异常在青斑样血管炎中的意义

目的探讨抗心磷脂抗体(ACA)和免疫异常在青斑样血管炎(LV)中的作用。方法两组均用药前取静脉血,用间接免疫荧光、免疫印迹、ELISA等方法测定LV患者体内抗核抗体、循环免疫复合物、免疫球蛋白、ACA、抗β2糖蛋白1(β2GP1)抗体的水平。结果LV组4例抗核抗体阳性,3例免疫复合物阳性,2例免疫球蛋白升高,其中2例诊断为系统性红斑狼疮。ACA阳性13(43.33%)例,β2GP1水平增高9(30.00%)例,其中3例合并下肢网状青斑样改变。对照组ACA阳性1例,无抗β2GP1抗体阳性者。两组ACA及抗β2GP1抗体阳性率差异有显著性意义(P均<0.01)。结论LV的发病与免疫复合物、免疫反应无明显相关性,ACA与LV血栓形成有关,与合并严重网状青斑患者的ACA和抗β2GP1抗体尤其相关。说明LV的发病与血凝异常及血栓形成有一定关系。

The Significance of Anti-cardiolipin and Immunologic Abnormality in The Livedoid Vasculitis

Objective To evaluate the significance of anti-cardiolipin and immunologic abnormality in the livedoid vasculitis.Methods Thirty patients with biopsy-proved livedoid vasculitis and thirty normal controls involved in the study.Indirect immunofluorescence,immunoblot and ELISA were used for detecting antinuclear antibody(ANA),circulating immune complex(CIC),immune globulin,ACA and anti-β2GP1.Results ANA were positive in 4 patients with LV,and among them,2 patients were diagnosed as SLE later.Addition to the 2 SLE patients,the level of ENA and immune globulin were normal in the rest of patients.Anticardiolipin antibodies were present in 13(43.33%)and β-Gp1 were present in 9(30.00%)of 30 patients,otherwise,anticardiolipin antibodies was positive in one and β-Gp1 were negative in all the control group,there were significant different between LV and controls(P<0.01).Conclusion LV is not related with immunologic abnormality and CIC.The level of ACA is one of important pathogenesis of Livedoid vasculitis.Numerous heterogeneous coagulation abnormalities and thrombogenesis may involve the LV.