β2糖蛋白I基因转染HEp-2细胞株中融合蛋白的表达及临床应用

目的：观察β2糖蛋白I（β2GPI）基因转染的HEp-2细胞（HEp-β2GPI)中β2GP I融合蛋白的过度表达,探讨以HEp-β2GP I为认错 物间接免疫荧光（IIF）法检测抗β2－GPI抗体的可行性,方法：应用逆转录聚合酶链反应（RT－PCR）扩增人源β2GP IcDNA,克隆人pEGFP-C1,并转染HEp-2细胞,通过RT－PCR,共焦荧光显微镜,免疫印迹法（IBT）及IIF鉴定βGPI－绿色荧光蛋白（GFP）融合蛋白的表达和抗原性,以转染细胞为底物IIF检测19份疑诊继发性抗磷脂综合征（APS）病人,1份原发性APS病人及10份正常人血清的IgG-β2GP I,与同时进行的ELISA法检测IgG-ACL,IgG-β2GP I的结果比较。结果：（1）获得的HEP－β2GPI细胞传十几休后仍具有较强的β2GP I－GFP表达,融合血清出现特征性免疫荧光表型,而正常人血清均无荧光染色,3种方法的比较性研究显示IIF法测IgG-β2GP I与ELISA法测IgG-β2GP I的一致性程度最佳（Kappa值0．886）,（3）HEp-β2GP I保持了原型HEp-2的细胞检测抗核抗体（ANA）的荧光特性,且检出2例原型HEp-2细胞IIF ANA是阴性的血清,结论：HEp-β2GP I转染细胞株可用于IIF检测抗β2GP I,而且仍可作为常规IIF ANA检测的底物。     

Trends of anticardiolipin antibodies after low-dose methylprednisolone and cyclophosphamide treatment of systemic lupus erythematosus

BACKGROUND: The aim of the study is to analyze retrospectively the effect of low-dose methylprednisolone (MP) and cyclophosphamide (CYC) pulse therapy on anticardiolipin antibodies (aCL) serum levels in patients with systemic lupus erythematosus (SLE). METHODS: For aCL determinations, a beta2-glycoprotein I-dependent enzyme-linked immunosorbent test (ELISA) was performed. Lupus anticoagulant was investigated by Russell venom time with platelet neutralization. Antinuclear antibodies were performed by standardized methods. All SLE patients (from a total of 137) with aCL determinations who were assayed before and after MP and CYC pulse therapy were included in the study. RESULTS: Nine patients had aCL determinations before and after MP-CYC pulse therapy. All active patients with SLE improved clinically without severe MP-CYC side effects; 21 had IgG-aCL determinations, and 19 IgM-aCL determinations (40 assays) were performed in all nine patients during the observation period (zero time to 21 months). Three patients had secondary antiphospholipid syndrome (APLS)-related clinical manifestations. In all patients, IgG aCL antibodies decreased significantly (p <0.05). CONCLUSIONS: Decrease of IgG aCL serum levels as a consequence of the MP-CYC therapy herein reported might help to redefine previous concepts with regard to modulation of antiphospholipid antibody (aPL) immune response by immunosuppressive therapy. These findings might also have prognostic and therapeutic implications in SLE, on pregnancy in SLE, and in antiphospholipid syndrome (APL) as well, although prospective studies are required.     

氧化型低密度脂蛋白抗体在抗磷脂综合征中的临床意义

目的：探讨氧化型低密度脂蛋白抗体(oxidized low-density lipoprotein antibodies, ox-LDL-Ab)在抗磷脂综合征(antiphospholipid syndrome, APS)中的分布及其临床意义。方法：共纳入334例患者,包括162例APS患者,122例无血栓或病态妊娠的其他自身免疫性疾病患者作为疾病对照,以及50例健康对照。收集APS患者的临床资料及实验室检查指标,采用酶联免疫吸附试验检测患者的ox-LDL-Ab、IgG/IgA/IgM型抗心磷脂抗体(anticardioli-pin, aCL)、IgG/IgA/IgM型抗β2糖蛋白Ⅰ抗体(anti-β2-glycoproteinⅠ, aβ2GPI)。采用统计软件SPSS 27.0分析ox-LDL-Ab与临床及实验室检查指标之间的相关性。结果：APS组60.5%的患者合并血栓,48.1%的患者出现病态妊娠,34.0%的患者合并血小板减少,aCL、aβ2GPI和狼疮抗凝物(lupus anticoagulant, LAC)的阳性率分别为17.9%、34.6%和46.9%。ox-LDL-Ab...     

Republished review: Ocular manifestations of the antiphospholipid syndrome

Antiphospholipid syndrome (APS) is an autoimmune disease characterised by a heterogenous group of antibodies directed against negatively charged phospholipids including antiphospholipid antibodies (aPL), anticardiolipin antibodies (aCL) and β-2 glycoprotein I (aβ-2-GP1). The major features of this disorder include arterial and venous thrombosis and recurrent fetal loss. The vasculature of the eye is frequently involved and may be the presenting manifestation. A diagnosis of APS should be considered in a young patients without traditional thromboembolic risk factors presenting with ocular vaso-occlusive disease. Management of these patients involves a team-approach with a haematologist/oncologist or rheumatologist to manage the coagulation status of these patients to prevent further systemic vascular occlusions.     

Anticardiolipin and anti-beta2-glycoprotein-I antibodies in hypertensive disorders of pregnancy

BACKGROUND: This study was undertaken in order to determine the frequency of anticardiolipin (aCL) and anti-beta2-glycoprotein-I antibodies (anti-beta2 GP-I) in patients with hypertensive disorders of pregnancy. METHODS: We studied aCL (IgG and IgM) and IgG anti-beta 2 GP-I by ELISA in the serum and IgG aCL and anti-beta 2 GP-I in the urine of 125 women with hypertensive disorders of pregnancy (cases) (75 had preeclampsia, 25 had eclampsia, and 25 had chronic hypertension). One hundred and twenty seven normal women were used as controls. Antibody positivity was defined as above the 90(th) percentile of the controls. RESULTS: We found no differences in frequency of serum anti-beta 2 GP-I or serum and urinary aCL between cases and controls. In contrast, we found that frequency of IgG anti-beta 2 GP-I was higher in the urine of cases (26.1%) compared to controls (9.4%, p = 0.001). Strength of association was stronger for urinary anti-beta2-glycoprotein-I in women with preeclampsia (odds ratio [OR] = 4.3, 95% confidence limit [CI 95%] = 1.95-9.62, p <0.0001). Cases and the subgroup of preeclamptic patients also had higher titers of urinary IgG anti-beta 2 GP-I than control women (p <0.0001). CONCLUSIONS: Our work suggests that urine testing is necessary in order to ascertain whether antibodies to beta(2)GP-I are associated with preeclampsia.     

14例恶性抗磷脂综合征病例报道及临床分析

目的: 恶性抗磷脂综合征(catastrophic antiphospholipid syndrome, CAPS),即Asherson综合征,是一种以累及多系统、脏器、组织的多发血管内血栓,高滴度的抗磷脂抗体和高死亡率为特征的一种抗磷脂综合征(antiphospholipid syndrome, APS)亚型。本文分析CAPS的临床表现、实验室检查及治疗,以增加对该病的认识及诊治水平。方法: 回顾性分析APS上海数据库的14例CAPS患者的临床资料并进行描述性统计分析。结果: 14例患者中12例符合2003年第10届抗磷脂抗体国际会议中通过的CAPS分类标准中的确诊APS,2例符合APS可能,其中原发性APS有3例,11例继发于系统性红斑狼疮(systemic lupus erythematosus,SLE)。感染是最常见的发病诱因,其次是狼疮活动和外科手术。临床事件中,动脉血栓最好发的部位为脑和肺,静脉血栓最常见于四肢静脉。抗心磷脂抗体(anticardiolipin antibody, aCL)、抗β2糖蛋白1抗体(anti-β2 glyeoprotein Ⅰ antibody, aβ2GPI)、狼疮抗凝物(lupus anticoagulant, LA)均阳性的患者占54.55%,血小板减少和血红蛋白降低发生于大部分的CAPS患者,其中大多证实为溶血性贫血。死亡病例6例,抗凝药物、激素、静脉注射丙种球蛋白和/或血浆置换的三联疗法可以改善患者的预后,合并SLE和微血管病性溶血性贫血的患者分别可以使用环磷酰胺和利妥昔单抗。结论: CAPS是急性发生的以大量微血栓形成及高抗磷脂抗体滴度为特点的危重症,可以导致多脏器功能衰竭,因本病预后差,及时的诊断和积极的治疗是改善预后的关键。     

抗β2GPI抗体测定在系统性红斑狼疮患者中的临床意义

目的探讨抗β2糖蛋白I抗体(aβ2GPI)在系统性红斑狼疮(SLE)诊治中的临床意义及与疾病活动性的关系。方法采用酶联免疫吸附法(ELISA)测定68例SLE患者及23例健康对照者血清中aβ2GPI浓度,同时记录SLE患者各项实验室指标和其他自身抗体的水平。对照分析aβ2GPI阳性与阴性患者实验室检测指标结果的差异。结果SLE患者中,aβ2GPI抗体阳性率为25%(17/68),健康对照组中未检出aβ2GPI。患者的SLE疾病活动性指数(SLEDAI)与aβ2GPI抗体浓度无相关性。aβ2GPI阳性SLE患者血小板减少、凝血酶原时间(PT)延长的发生率高于aβ2GPI阴性组(<0.05)。aβ2GPI检测结果与aCL检测结果间存在正相关性。结论部分SLE病例中可检出抗β2GPI抗体。抗β2GPI抗体浓度与SLE疾病活动性无明显相关。抗β2GPI抗体与SLE患者发生血小板减少、凝血酶原时间延长等事件相关。     

可溶性内皮糖蛋白在抗磷脂综合征患者的血清水平及临床意义

目的: 检测可溶性内皮糖蛋白(soluble endoglin,s-Eng)在抗磷脂综合征(antiphospholipid syndrome,APS)患者的血清水平并分析其潜在临床意义。方法: 采用酶联免疫吸附试验方法检测139例APS患者[原发性APS患者64例,继发于系统性红斑狼疮(systemic lupus erythematosus,SLE)的APS患者75例]、44例不符合APS诊断的单纯SLE患者、37例原发性干燥综合征(primary sjogren syndrome,pSS)患者、23例白塞病(Behcet’s disease,BD)患者、22例系统性硬化病(systemic sclerosis,SSc)患者、22例持续抗心磷脂抗体(anticardiolipin antibody,aCL)阳性但无法诊断SLE或APS者(单纯aCL阳性组)及87例健康对照(health control,HC)的s-Eng血清水平,分析APS患者外周血s-Eng水平与其临床及实验室表现的关系。数据分析采用 t检验、方差分析、Mann-Whitney U 检验、Pearson’s χ ²检验。 结果: (1)APS患者血清s-Eng水平[(10.15±4.64) mg/L]显著高于其他风湿病患者[单纯SLE(5.55±2.51) mg/L,pSS(5.32±2.34) mg/L,BD(4.58±1.53) mg/L, SSc(7.11±4.18) mg/L]、单纯aCL阳性组[(5.17±2.00) mg/L]及HC组[(5.04±1.11) mg/L],P均小于0.001。原发性APS患者与继发于SLE的APS患者血清s-Eng水平差异无统计学意义[(9.83±5.15) mg/L vs. (10.42±4.18) mg/L,P =0.12]。单纯aCL阳性组血清s-Eng水平与HC组差异无统计学意义[(5.17±2.00) mg/L vs.(5.04±1.11) mg/L, P>0.05]。(2)以正常对照者血清s-Eng的 \stackrel{\text{-}}{x} ±3s作为诊断APS的cut-off值,将APS患者血清s-Eng≥8.37 mg/L设为s-Eng阳性组,对应的敏感性为0.772,特异性为0.928;约登指数为0.700。(3)s-Eng阳性组患者出现动脉血栓事件、病态妊娠比例显著高于s-Eng阴性组患者[分别为46/81 vs. 19/58, P<0.05; 29/65 vs. 10/44, P<0.05];s-Eng阳性组患者的血小板水平显著低于s-Eng阴性组患者(72.00×10 ⁹/L vs. 119.00×10 ⁹/L, P<0.001)。(4)s-Eng阳性组患者抗心磷脂抗体(anticardiolipin antibody,aCL)阳性的比例(93.83% vs. 37.93%, P<0.001)及抗体滴度(61.70 U/mL vs. 15.45 U/mL,P<0.001)均高于s-Eng阴性组。抗β2-糖蛋白Ⅰ抗体阳性的比例(61.73% vs. 43.10%, P<0.05)及抗体滴度(33.48 U/mL vs. 17.40 U/mL,P<0.05)也均高于s-Eng阴性组。 结论: s-Eng在APS患者血清中异常升高,其有可能为APS的诊断及风险预测提供一个血清学标志的补充。     

阿托伐他汀对Ox-LDL/β2GPⅠ/anti-β2GPⅠ诱导的血管内皮功能紊乱的改善作用及其机制

目的:探讨阿托伐他汀(ATO)对氧化低密度脂蛋白(Ox-LDL)/β2糖蛋白Ⅰ(β2GPⅠ)/抗β2糖蛋白Ⅰ抗体(anti-β2GPⅠ)复合物引发的血管内皮细胞损伤的改善作用以及对TRAF3-相互作用蛋白2(TRAF3IP2)/Ikappa B激酶(IKK)/核因子κB(NF-κB)信号通路的影响,阐明ATO改善抗磷脂...     

The antiphospholipid antibody syndrome research in patients with retinal venous occlusion

BACKGROUND: The antiphospholipid antibody syndrome (APAS) is a condition associated with abnormal thrombosis and the presence of anticardiolipin antibodies (aCL). METHODS: Thirty-two patients (20 male and 12 female) aged between 29 and 75 years (mean +/- SD: 56.4 +/- 12.34) with retinal venous occlusive disease were studied. All patients with a history of venous occlusive disease within the previous 8 months were included in the study. Diagnoses were made by fundus examination and fundus fluorescein angiography (FFA). Anticardiolipin IgM and IgG antibodies, antinuclear antibodies (ANA), and IL-1beta were investigated in all patients. RESULTS: Neither aCL-IgM nor aCL-IgG was observed as positive in this group. Only four patients were found to be ANA positive. However, serum levels of IL-1beta were higher than those of controls (p <0.001). Mean IL-1beta was found to be 18.06 +/- 3.39 pg/mL (mean +/- SE), respectively. IL-1beta levels were found to be significantly different from those of controls (2.7 +/- 0.68 pg/mL) (p <0.001). In this study, antiphospholipid antibody positivity was not determined in any patients. CONCLUSIONS: As a result, IL-1beta level appears higher in retinal venous occlusive disease. This cytokine measurement might be used as a diagnostic indicator for venous occlusive disease.     

Anti-cardiolipin, anti-cardiolipin plus bovine, or human beta(2)glycoprotein-I and anti-human beta(2)glycoprotein-I antibodies in a healthy infant population

BACKGROUND: Pathogenic antiphospholipid antibodies studies are usually conducted on populations of adults. Studies involving normal children are scant. METHODS: Antibody reactivity against CL alone (true aCL), CL-complexed to bovine beta(2)GP-I (aCL-bovine beta(2)GP-I), or human (aCL-human beta(2)GP-I) beta(2)GP-I, or to phospholipid-free human beta(2)GP-I (anti-human beta(2)GP-I) was determined by ELISA in serum samples from 360 Mexican children ranging from 1 month through 8 years of age. RESULTS: Statistical analysis of variance and rankings of Kruskal-Wallis demonstrated no significant difference in all tested antibody activities between ages and genders of the study population. Values are presented as a percentile distribution included between 5 and 99, corresponding to the percentages of the studied population. Normal arbitrary units (AU) for IgG, IgA, and IgM true aCL that correspond to the 95 and 99 percentiles are as follows: 2.15 and 3.5; 2.35 and 5.0, and 3.15 and 4.5, respectively. IgG, IgA, and IgM aCL-bovine beta(2)GP-I activities are 2.6 and 5.0, 3.0 and 5.0, and 2.7 and 6.0 AU, respectively, while IgG activities of aCL-bovine and human beta(2)GP-I are 1.45 and 1.80, respectively. Normal values for IgG anti-human beta(2)GP-I are 1.85 AU. CONCLUSIONS: While elevated serum levels of antibodies to CL and/or beta(2)GP-I have been associated with thrombotic and hematologic manifestations, the majority of reports deal with adult populations. We report the cut-off values (in AU, international PL units, and international units for beta(2)GP-I) of the specific serologic response of true aCL, aCL-bovine beta(2)GP-I, aCL-human beta(2)GP-I, and anti-human beta(2)GP-I in healthy Mexican children.     

Significance of Laboratory and Clinical Manifestations of Antiphospholipid Syndrome

##正##Clinical features of antiphospholipid syndrome Antiphospholipid syndrome(APS) is a form of immune mediated thrombophilia,characterized by thrombosis, recurrent fetal death and the presence of circulating antiphospholipid(aPL) antibodies directed against anionic phospholipids or protein-phospholipid complexes. Almost every vascular bed can be involved by thrombosis     

抗磷脂综合征患者血栓事件的危险因素分析

目的：探讨影响抗磷脂综合征（antiphospholipid syndrome, APS）患者血栓事件发生的危险因素。方法：回顾性分析北京大学人民医院收治的61例APS患者血栓事件的发生特点,评价血栓事件与患者临床及免疫学指标的相关性,包括性别、年龄、有无血小板减少、吸烟、高血压、糖尿病、高脂血症和抗磷脂抗体等。结果：70.49% APS患者发生血栓事件,其中动脉血栓发生率36.67%,静脉血栓发生率39.34%,下肢静脉血栓和脑梗塞最常见,分别占37.7%和24.59%,其次为肺栓塞、血栓性微血管病、肾梗死和脾梗死。抗心磷脂抗体阳性和高血压分别是静脉和动脉血栓事件的独立危险因素。结论：抗心磷脂抗体阳性者易发生静脉血栓,而合并高血压的APS患者易发生动脉血栓。     

抗磷脂综合征57例临床分析

目的 分析抗磷脂综合征（antiphospholipid syndrome,APS）的临床表现、诊断及治疗,以提高本病的诊治水平.方法 回顾性分析2004-2013年在本院诊断明确的57例APS患者的临床特征和免疫学特点.结果 57例中男性14例（24.6％）,女性43例（75.4％）,确诊时平均年龄（37±14）岁;原发性APS 21例（36.8％）,继发性APS 36例（63.2％）.血栓发生率71.9％,血栓复发率41.5％,原发性APS的血栓复发率高于继发性APS（P＜0.05）;病态妊娠发生率63.3％.本组患者65.4％抗心磷脂抗体（anticardiolipin antibodies,ACL）阳性,71.9％抗β2-糖蛋白Ⅰ抗体阳性,42％血小板减少.在确诊APS前,43.9％被诊断为血栓事件,33.3％被诊断为自身免疫性疾病,8.8％被诊断为血小板减少.结论 APS临床表现以血栓形成、病态妊娠为主,免疫学特点为高滴度的ACL和（或）抗β2-糖蛋白Ⅰ抗体阳性.APS临床症状多样化导致其误诊率较高.     

Management of antiphospholipid antibody syndrome: a systematic review

Context  Antiphospholipid antibodies are autoantibodies directed against proteins that bind to phospholipid. Antiphospholipid antibody syndrome (APS) refers to the association between antiphospholipid antibodies and thrombosis risk or pregnancy morbidity. Patients with APS may be at increased risk of recurrent arterial or venous thrombosis or pregnancy loss. Objective  To systematically review the evidence for treatment of thrombosis risk in patients with antiphospholipid antibodies or APS. Evidence Acquisition  Search of MEDLINE (1966 to November 2005) and Cochrane Library electronic databases (2005) and reference lists for randomized trials, meta-analyses of randomized trials, and prospective cohort studies of the treatment of thrombosis risk in patients with antiphospholipid antibodies or APS. Studies were selected on the basis of clinical relevance. Evidence Synthesis  Among patients with antiphospholipid antibodies, the absolute risk of developing new thrombosis is low (<1% per year) in otherwise healthy patients without prior thrombotic events, may be moderately increased (up to 10% per year) in women with recurrent fetal loss without prior thrombosis, and is highest (>10% in the first year) in patients with a history of venous thrombosis who have discontinued anticoagulant drugs within 6 months. Compared with placebo or untreated control, anticoagulation with moderate-intensity warfarin (adjusted to a target international normalized ratio [INR] of 2.0-3.0) reduces the risk of recurrent venous thrombosis by 80% to 90% irrespective of the presence of antiphospholipid antibodies and may be effective for preventing recurrent arterial thrombosis. No evidence exists that high-intensity warfarin (target INR, >3.0) is more effective than moderate-intensity warfarin. For patients with a single positive antiphospholipid antibody test result and prior stroke, aspirin and moderate-intensity warfarin appear equally effective for preventing recurrent stroke. Treatment issues that have not been addressed in clinical trials, or for which the evidence is conflicting, include the role of antithrombotic prophylaxis in patients with antiphospholipid antibodies without prior thrombosis, the optimal treatment of noncerebrovascular arterial thrombosis, recurrent thrombosis despite warfarin therapy, and treatment of women with antiphospholipid antibodies and recurrent fetal loss. Conclusions  In patients with APS, moderate-intensity warfarin is effective for preventing recurrent venous thrombosis and perhaps also arterial thrombosis. Aspirin appears to be as effective as moderate-intensity warfarin for preventing recurrent stroke in patients with prior stroke and a single positive test result for antiphospholipid antibody. The optimal treatment of other thrombotic aspects of APS needs to be addressed in well-designed prospective studies.      

淋巴瘤患者血清中抗磷脂自身抗体的临床及免疫学意义

目的 了解淋巴瘤患者血清中抗磷脂抗体( APL)的阳性率及水平,探讨抗磷脂抗体淋巴瘤患者中的临床和免疫学意义.方法 应用ELISA法检测129例淋巴瘤、46例系统性红斑狼疮(SLE)、38例类风湿关节炎(RA)、24例原发性干燥综合征(pSS)及58名健康对照的血清中的抗心磷脂抗体IgG/M/A和抗β2糖蛋白Ⅰ抗体IgG/M/A,分析其与淋巴瘤患者一般情况、临床特点、免疫学表型及血栓事件的关系.结果 (1)抗磷脂抗体在淋巴瘤患者血清中的阳性率为40.3％ (52/129),其中抗心磷脂抗体阳性率11.6％ (15/129),抗β2糖蛋白Ⅰ抗体阳性率32.6％ (42/129).抗心磷脂抗体及抗β2糖蛋白Ⅰ抗体在淋巴瘤患者血清中的水平及阳性率均明显高于健康对照组(P＜0.05),4与SLE、RA、pSS组的抗体水平相仿(P＞0.05).(2)T或NK/T细胞淋巴瘤中抗磷脂抗体阳性率明显高于B细胞淋巴瘤(P＜0.05).(3)抗磷脂抗体阳性与阴性的淋巴瘤患者中血栓事件的发生率差异无统计学意义.(4)抗磷脂抗体阳性淋巴瘤患者的无事件生存时间短于抗磷脂抗体阴性者.结论 抗磷脂抗体在淋巴瘤患者血清中的阳性率及抗体水平均较健康人群明显升高,与SLE等自身免疫病患者无明显差别.抗磷脂抗体多见于T或NK/T细胞来源的非霍奇金淋巴瘤.抗磷脂抗体可能与淋巴瘤患者的无事件生存时间有关.     

产科抗磷脂综合征诊治现状与研究进展

抗磷脂综合征（antiphospholipid syndrome,APS）是一种自身免疫性疾病,可累及多器官及多系统。在妊娠期间由于孕妇血流动力学的改变,一旦合并APS可使机体处于高凝状态,因此极易发生胎盘血栓形成。同时抗磷脂抗体（antiphospholipid antibody,aPL）可通过破坏滋养细胞功能等多种机制造成子痫前期、胎儿生长受限、胎儿宫内死亡及其他不良结局。APS患者一旦发生产科合并症则被称为产科抗磷脂综合征（obstetric APS,OAPS）。本文就OAPS的诊断及分型、与不良妊娠结局的相关性、诊治现状及远期随访进行文献综述,以期为临床工作提供指导。     

抗β_2糖蛋白I抗体在SLE血栓形成中的临床意义

系统性红斑狼疮(SLE)是一种自身免疫介导的弥漫性结缔组织病,是继发性的抗磷脂综合征(APS)的典型代表。抗β2糖蛋白I(β2-GPI)抗体是APS的一种主要抗体,是沟通免疫和凝血两大生理系统的桥梁之一。但β2-GPI抗体阳性的SLE患者中,只有部分发生血栓/栓塞。人群中抗β2-GPI抗体不仅可分为不同的亚型,更存在不同的亚群,可识别抗原不同的功能区,并与血栓事件之间存在不同的关联性。该文就β2-GPI抗体的研究进展予以综述。     

aGL阳性流产患者治疗120例报告

目的通过对120例aCL阳性流产患者的回顾性研究.探讨流产与抗心磷脂抗体(aCL)的关系及aCL流产者的治疗方法.方法242例因自然流产住院的患者,采用免疫金标法测定aCL(IgA、IgG、IgM),对aCL阳性流产者根据病情予以传统治疗或ApS治疗,追踪妊娠结局.结果120例aCL阳性流产者治疗后,84例追踪到妊娠结局,成功率70.24%,其中APS治疗成功率71.64%.1次流产的患者传统治疗成功率91.67%,APS治疗成功率77.14%,两者无统计学差异(P＞0.05);2次及2次以上流产患者,传统治疗5例,无1例成功,APS治疗成功率65.63%,两者有显著性差异(P＜0.05).结论aCL阳性流产患者的APS治疗成功率71.64%,尤其对于2次及2次以上流产患者,成功率明显高于传统治疗(P＜0.05).aCL阳性流产患者治疗后,结局明显改善,与对照组比较无显著性差异(P＞0.05).根据aCL和血液粘稠度选用强的松和/或小剂量阿司匹林作为常规治疗,疗效不好者加用低分子肝素和/或蓉生静丙治疗,效果显著.     

Activated protein C resistance in antiphospholipid thrombosis syndrome

Objective To explore the correlation between antiphospholipid antibodies (APA)，activated protein C resistance (APCR) and antiphospholipid thrombosis (APL-T) syndrome and further investigate the mechanism of thrombosis in APL-T syndrome. Methods ELISA, PTT-LA and APTT±APC methods were used to detect anticardiolipin antibodies (ACA), lupus anticoagulants (LA) and APC R in 20 APL-T syndrome patients. Results Twenty patients were diagnosed as APL-T. ACA-IgG,M and LA are strongly associated with APL-T. The incidence of APCR in APL-T(75%) was significantly higher than that of the normal group (5%). Conclusion There was high prevalence of APCR in APL-T, which was strongly associated with LA. It is proposed that acquired APCR induced by APA is a key to understanding thrombosis in Chinese APL-T patients.