系统性红斑狼疮患者抗心磷脂抗体的检测及其临床意义

目的测定ACA在SLE中出现的频率及其在SLE中的临床意义.方法应用酶联免疫吸附试验(ELISA)对30例SLE患者血清中ACA进行检测,并以正常人血清作对照.结果1.正常人IgG、IgM、IgA型ACA的结合指数(BI)值分别为1.48±0.43、1.46±0.43和1.00±0.33.2.SLE组BI值IgG-ACA、IgM-ACA、IgA-ACA分别为3.04±1.25、3.07±1.61、1.96±1.05,与正常组BI值比较差异均有显著性意义(P＜0.05).3.ACA与SLE患者部分临床表现如血小板减少、血管炎、肾脏病变、雷诺现象及实验室指标如低补体C3有一定的相关关系.4.ACA与抗核抗体(ANA)之间呈直线相关,ANA分别与IgG-ACA相关,r＝0.912;与IgM-ACA相关,r＝0.870;与IgA-ACA相关,r＝0.758.P值均＜0.01.结论1.SLE组ACA值显著高于正常对照组.2.ACA与SLE患者血管损害、血小板减少等密切相关.3.各型ACA与ANA存在直线相关关系,说明ACA值可以作为评价SLE病情严重程度的指标之一.     

系统性红斑狼疮患者自身抗体与HLA-DR、DQ基因的相关性研究

目的 探讨系统性红斑狼疮（ＳＬＥ）的发病机理和遗传基础。方法 分析了ＳＬＥ患者中各种自身抗体与ＨＬＡ－ＤＲ、ＤＱ基因的关联。结果 发现抗Ｒｏ抗体与ＤＲ２、ＤＱ６及ＤＱ２／ＤＱ６杂合子相关，抗ＲＮＰ抗体与ＤＱＡ１＊０１０２、ＤＱＢ１＊０６０２相关。抗Ｓｍ和抗ｄｓＤＮＡ抗体均与ＤＲＢＱ＊１５０１、ＤＱＡ１＊０１０２、ＤＱＢ１＊０６０２相关，这与汉族ＳＬＥ与ＨＬＡ的关联完全一致，表明抗Ｓｍ和抗ｄｓＤＮＡ     

抗心磷脂抗体与系统性红斑狼疮的血管损害

抗放磷脂抗体展开一种抗磷脂抗体，其与系统性红斑狼疮的关系已经越来越引起人们的重视。以入研究较多的是抗磷脂抗体综合征。本文着重阐述抗心磷脂抗体与系统性红斑狼疮血管损害的关系。     

抗磷脂抗体综合征与系统性红斑狼疮

抗磷脂抗体综合征系一种自身免疫性疾病、与系统性红斑狼疮关系密切，其许多临床症状与系统性红斑狼疮相同或相似，且约有２０％的系统性红斑狼疮患者可合并抗磷脂抗体综合征。本文就抗磷脂抗体综合征的主要临床表现、发病机理、诊断标准、系统性红斑狼疮合并抗磷脂抗体综合征的临床特点及治疗等方面进行了归纳。     

以贫血为首发症状的系统性红斑狼疮误诊1例

系统性红斑狼疮（SLE）是一种累及多系统、多器官并有多种自身抗体出现的自身免疫性疾病。育龄女性多见，也可见于儿童和老年人。SLE基本病理改变是免疫复合物所介导的血管炎。遗传、感染、环境、性激素、药物等多种综合因素所致的免疫紊乱导致了该病的发生。现将我院2005年2月收治的1例以贫血为首发症状的SLE患者，将误诊误治经过，及时转诊，明确诊断患者疾病，得到及时治疗的情况报告如下。     

抗心磷脂抗体与系统性红斑狼疮的血管损害

抗心磷脂抗体属于一种抗磷脂抗体,其与系统性红斑狼疮的关系已经越来越引起人们的重视。以往研究较多的是抗磷脂抗体综合征。本文着重阐述抗心磷脂抗体与系统性红斑狼疮血管损害的关系。     

系统性红斑狼疮患者抗磷脂抗体的检测

目的探讨抗磷脂抗体(APA)在正常人的分布及其与系统性红斑狼疮(SLE)的关系。方法应用酶联免疫吸附实验(ELISA)检测82例正常人和32例SLE患者血中6种APA。结果正常人IgG型抗心磷脂抗体(aCL)、抗磷脂酰肌醇抗体(aPI)、抗磷脂酸抗体(aPA)、抗磷脂酰乙醇胺抗体(aPE)、抗磷脂酰丝氨酸抗体(aPS)和抗磷脂酰胆碱抗体(aPC)的阳性率分别为6.10%、6.10%、7.32%、7.32%、3.66%和3.66%,IgM型aCL、aPA、aPC、aPS、aPE和aPI的阳性率分别为2.44%、3.66%、3.66%、6.10%、6.10%和4.88%。SLE患者IgG型aCL、aPA、aPS、aPC、aPI的A值和阳性率显著高于正常人,IgM型aCL、aPA、aPS、aPE、aPC的A值和阳性率显著高于正常人;SLE时IgG和IgM型APA的总阳性率分别为68.75%和71.88%。结论在正常人中存在滴度较低的APA;这些APA互相间有一定的关系,多同时出现。SLE时进行APA检查,对抗磷脂综合征的诊断可能有一定的意义。     

抗磷脂抗体综合征与系统性红斑狼疮

抗磷脂抗体综合征系一种自身免疫性疾病,与系统性红斑狼疮关系密切,其许多临床症状与系统性红斑狼疮相同或相似,且约有20％的系统性红斑狼疮患者可合并抗磷脂抗体综合征。文中就抗磷脂抗体综合征的主要临床表现、发病机理、诊断标准、系统性红瘫狼疮合并抗磷脂抗体综合征的临床特点及治疗等方面进行了归纳。     

系统性红斑狼疮患者血清抗血管内皮细胞抗体及抗心磷脂抗体的检测

抗血管内皮细胞抗体(AECA）是一组针对血管内应细胞膜表面抗原系统的异质型抗体．其出现、滴度及其所针对的抗原的抗原谱与原发性系统性血管炎和继发性血管炎的临床过程密切相关，其致病机制可能是通过改变血管内皮细胞功能而发挥作用。抗心磷脂抗体(ACA)与SLE相关．尤其与SLE血栓形成密切相关。但对其能否作为判断SLE商情活动及预后的     

以假性肠梗阻为首发表现的系统性红斑狼疮5例

报告5例以假性肠梗阻为首发表现的系统性红斑狼疮.5例中的2例有间质性膀胱炎表现,予以甲泼尼龙、环磷酰胺治疗后症状缓解.以假性肠梗阻为首发表现的系统性红斑狼疮临床上少见.及早使用糖皮质激素及免疫抑制剂,避免不适当的外科干预是提高疗效的关键.     

系统性红斑狼疮并发横贯性脊髓炎

报告1例系统性红斑狼疮(SLE)并发横贯性脊髓炎.患者女,23岁.患SLE 5个月,突然出现双下肢乏力、感觉缺失、排便困难3 d就诊.体格检查示脐以下皮肤感觉障碍明显,双侧膝、腱反射( ),Babinski征( ),Chaddock征( ).脊髓磁共振成像(MRI)检查可见颈3～胸12水平脊髓内片状高信号.给予甲泼尼龙冲击治疗有效.     

Oxidative stress as a potential causal factor for autoimmune hemolytic anemia and systemic lupus erythematosus

The kidneys and the blood system mutually exert influence in maintaining homeostasis in the body. Because the kidneys control erythropoiesis by producing erythropoietin and by supporting hematopoiesis, anemia is associated with kidney diseases. Anemia is the most prevalent genetic disorder, and it is caused by a deficiency of glucose 6-phosphate dehydrogenase(G6PD), for which sulfhydryl oxidation due to an insufficient supply of NADPH is a likely direct cause. Elevated reactive oxygen species(ROS) result in the sulfhydryl oxidation and hence are another potential cause for anemia. ROS are elevated in red blood cells(RBCs) under superoxide dismutase(SOD1) deficiency in C57BL/6 mice. SOD1 deficient mice exhibit characteristics similar to autoimmune hemolytic anemia(AIHA) and systemic lupus erythematosus(SLE) at the gerontic stage. An examination of AIHA-prone New Zealand Black(NZB) mice, which have normal SOD1 and G6 PD genes, indicated that ROS levels in RBCs are originally high and further elevated during aging. Transgenic overexpression of human SOD1 in erythroid cells effectively suppresses ROS elevation and ameliorates AIHA symptoms such as elevated anti-RBC antibodies and premature death in NZB mice. These results support the hypothesis that names oxidative stress as a risk factor for AIHA and other autoimmune diseases such as SLE. Herein we discuss the association between oxidative stress and SLE pathogenesis based mainly on the genetic and phenotypic characteristics of NZB and New Zealand white mice and provide insight into the mechanism of SLE pathogenesis.     

Systemic lupus erythematosus with C1q deficiency

We report a case of systemic lupus erythematosus associated with C1q deficiency. Our patient presented at the age of 6 years with cutaneous lupus. She later developed Raynaud's phenomenon, non-scarring alopecia, oral ulceration and grand mal seizures due to cerebral vasculitis. Complement C3 and C4 levels were consistently normal during flares of her lupus and haemolytic activity of her complement was absent, suggesting a deficiency of an early component of the complement cascade. No C1q could be detected.     

系统性红斑狼疮关节畸形并双侧髌韧带断裂

报道1例女性系统性红斑狼疮（SLE）患者长期服用皮质类固醇12年，出现关了畸形并双侧髌韧带断裂，临床表明：双手多个指，掌指，腕关节呈Jaccoud's畸形，韧带松驰，过伸，捏起功能障碍，活动轻度受限，感觉正常，X线显示：双手多个指，掌指关节松驰，排列紊乱，或完全脱位；双侧尺腕关节呈对称性关脱位，双侧膝关节髌骨上移，可见髌韧带断裂阴影，左肘关节下方尺背侧软组织内见钙化影，所有关节未见侵蚀性骨损害及骨硬化。     

系统性红斑狼疮165例临床分析

目的：探讨165例SLE住院患者的临床特点。方法：对165例SLE患者的临床资料进行了回顾性分析。结果：肾损害总发生率最高达78.5%。少年组蝶形红斑、肾损害、脱发等发生率较高,病情进展快,2例发生狼疮危象。老年组起病不典型,自身抗体阳性率较低。男女患者临床表现及免疫学特征无显著差异,但男性患者内脏受累较重。结论：本院165例SLE住院患者,肾损害发生率高,少年组病情进展快,老年组起病不典型,男性组症状较重。     

SLE与妊娠关系的研究进展

SLE好发于生育期女性,不可避免地会面临生育问题.近年来SLE女性患者妊娠已不视为禁忌.妊娠对SLE的病情会有影响,可诱发或加重SLE;相反,SLE也会影响妊娠的过程和结局,易发生流产、死胎、死产等胎儿丢失情况及胎儿生长受限,也可发生新生儿红斑狼疮.了解可能影响妊娠及胎儿的免疫学变化和激素水平变化,掌握SLE患者的妊娠指征,合理用免疫抑制剂及正确的护理,在控制SLE活动的基础上,使患者分娩正常的胎儿,是临床医师面临的重要课题.     

Systemic lupus erythematosus induced by Epstein-Barr virus infection

We report a 22-year-old woman who developed systemic lupus erythematosus (SLE) immediately after an Epstein-Barr virus (EBV)-induced mononucleosis infection. The link between these two conditions has long been suspected. The close temporal relationship, the course of the pathological events and the development of immunological changes in this case provide further evidence supporting the hypothesis that EBV infection could work as a trigger in some cases of SLE, particularly if the patient is genetically susceptible.     

Digital gangrene: a rare skin symptom in systemic lupus erythematosus.

A case of digital gangrene in a patient with systemic lupus erythematosus without secondary anti-phospholipid syndrome is reported. The acute onset of the necrotizing acrovasculitis occurred without a history of Raynaud's phenomenon. Preceding symptoms of the systemic lupus erythematosus were arthritis, photosensitivity, alopecia and anorexia. Despite the seriousness of the acute episode the patient achieved an excellent outcome.