抗凝血酶原抗体与系统性红斑狼疮的临床相关性

目的检测抗凝血酶原抗体（aPT）在系统性红斑狼疮（SLE）患者血清中的含量，以进一步辅助SLE的诊断及治疗。方法应用间接ELISA法检测系统性红斑狼疮患者血中的aPT（IgG及IgM型），应用商品抗磷脂抗体筛查试剂盒检测患者的总抗磷脂抗体（IgG及IgM型），同时计算其阳性率和优势比（OR，95％置信区间）。结果30例SLE患者的IgG、IgM、IgG＋IgM-aPL阳性率分别为36．7％、26．7％和46．7％，对照组分别为2．5％、5．0％和7．5％，P〈O．05，两者差异有统计学意义。IgG、IgM、IgG＋IgM-aPT的阳性率分别为20．0％、16．7％和26．7％；健康对照组分别2．5％、2．5％和5．O％，P值均〈O．05，差异有统计学意义，不论抗磷脂抗体（aPL）或aPT在SLE患者中均高于正常人。结论aPL和aPT在SLE患者血清中有较高的水平，检测这些患者血中的aPT及aPL，将有助于进一步完善抗磷脂综合征的临床研究及这些疾病的预防、诊断及治疗。     

抗凝血素抗体与自身免疫性自然流产的关系及其诊断价值

[目的]探讨抗凝血素抗体(anti- prothrombin antibodies aPT)与自身免疫性自然流产关系及其诊断价值 .[方法]通过病例对照研究的方法,用酶联免疫吸附实验(ELISA)检测60名有自然流产的患者(研究组)及20名正常妇女(对照组)的血清中抗凝血素抗体(aPT)IgG、IgM水平,同时与抗心磷脂抗体ACA的检测相比较.[结果]①研究组aPT-IgG和IgM浓度分别为6.71±2.11 U/ml 和5.30±1.71 U/ml;对照组aPT-IgG和IgM浓度分别为4.48±1.42 U/ml和4.00±1.11 U/ml,研究组aPT-IgG和IgM浓度水平均显著高于对照组 (P＜0.01).②研究组aPT阳性率为35.00%,对照组为5.00%,两组比较差异有统计学意义(P＝0.021,P＜0.05),研究组ACA阳性率为65.00%,对照组为15.00%,两组比较差异有显著性(P＜0.01).aPT阳性率、敏感度、准确度及误诊率(假阳性率)均低于ACA,而aPT特异度、漏诊率(假阴性率)高于ACA.[结论]①aPT 与自身免疫性自然流产有关.②aPT可在自身免疫性自然流产及APS诊断过程中作为辅助诊断指标,但aPT的敏感度低,漏诊率高,故它的临床应用价值有待于进一步研究.     

冠心病患者血清抗Cpn抗体及ICAM、CRP、IL-6的水平

目的探讨冠心病(CHD)患者血清中抗肺炎衣原体(Cpn)抗体、细胞间黏附分子-1(ICAM-1)及C反应蛋白(CRP)的水平及其临床意义。方法经临床确诊的CHD病人300例,以342例查体健康者作为对照组,用ELISA法分别检测血清抗Cpn IgA、IgG、IgM抗体及ICAM-1、CRP、IL-6水平。结果CHD患者血清抗Cpn IgA抗体阳性率显著高于对照组(P<0.01),抗Cpn IgM抗体则与对照组无显著差异;急性心肌梗死(AMI)及不稳定心绞痛(UAP)患者抗Cpn IgG抗体阳性率明显高于对照组(P<0.05)。CHD病人血清ICAM-1、CRP及IL-6也明显高于对照组。结论抗Cpn抗体的高阳性率与冠心病之间存在联系,而CHD患者血清ICAM-1、CRP及IL-6水平的升高也提示炎症反应在冠心病的发生发展中起重要作用。     

不孕不育患者血清中抗精子抗体与抗心磷脂抗体的检测价值

目的探讨抗精子抗体(AsAb)、抗心磷脂抗体(ACA)在不孕不育患者中的检测价值。方法采用酶联免疫吸附试验检测878例不孕不育患者及20例健康对照组血清中的AsAb及ACA。结果不孕不育组抗精子总抗体(AsAbT)的总阳性率为21.4%,IgM阳性率为13.5%;健康组AsAbT总阳性率为7.5%,IgM为0%,P<0.01。不孕不育组ACA检测总阳性率为36.6%,其中IgA阳性率为5.1%,IgG阳性率为30.5%,IgM为12.3%;健康组阳性率为5.0%,其中IgG阳性率为5.0%,IgM为2.5%,P<0.05。结论 AsAb、ACA与不孕不育关系密切,其检测有助于免疫性不孕不育的诊断。     

急性心肌梗死与柯萨奇B组病毒感染关系的研究

目的　探讨柯萨奇B组病毒感染与急性心肌梗死 (AMI)的发病关系。方法　应用SPA吸收IgG结合间接ELISA法检测AMI患者血清中柯萨奇B组病毒特异性IgM抗体及中和抗体。结果　 4 8例AMI患者血清特异性IgM抗体阳性率为 75 % ,血清中和抗体阳性率为 85 4 % ,与正常对照组相比差异非常显著。双份血清试验 ,恢复期血清抗体效价高于初期血清抗体效价 4倍以上。结论　AMI发病与柯萨奇B组病毒感染有关。     

女性不孕症患者抗心磷脂抗体和抗β_2-糖蛋白1抗体的检测及临床应用

目的探讨不同亚型(IgG和IgM)抗心磷脂抗体(aCL)和抗β_2糖蛋白Ⅰ抗体(anti-β_2GPⅠ)与女性不孕症的关系。方法选取2015年5~8月大连市妇女儿童医疗中心确诊的女性不孕症患者296例和同期的健康体检者31例,应用化学发光法对两组的IgG和IgM型aCL和anti-β_2GPⅠ进行检测。计算女性不孕症组及健康对照组中不同亚型抗磷脂抗体的阳性率,两组间抗体浓度分布的比较采用Mann-Whitney U检验。结果 aCL IgG在女性不孕症和健康组中的阳性率分别为0.34%和0.00%,aCL IgM在女性不孕症和健康组中的阳性率分别为1.35%和0.00%,β_2GPⅠIgG在女性不孕症和健康组中的阳性率均为0.00%,β_2GPⅠIgM在女性不孕症和健康组中的阳性率分别为0.34%和0.00%。aCL IgG在两组间的比较差异有统计学意义(P=0.013),其余三项指标女性不孕症组与健康对照组检验差异均无统计学意义。结论实验室还要进一步检测狼疮样抗凝物(LA),综合上述指标,排除女性不孕症患者中患有抗磷脂综合征的患者,为后续治疗奠定实验室基础。     

新型冠状病毒IgM和IgG抗体不同检测方法在新型冠状病毒感染中的临床应用评价

目的探讨新型冠状病毒(SARS-CoV-2)IgM和IgG抗体不同检测方法在新型冠状病毒肺炎(COVID-19)中的应用。方法选取25例COVID-19患者,以同期20例排除SARS-CoV-2感染的患者作为对照组,分别采用磁微粒化学发光法和胶体金法检测所有对象的血清SARS-CoV-2 IgM和IgG抗体。同时检测COVID-19患者血清降钙素原(PCT)、铁蛋白及C反应蛋白(CRP)。结果化学发光法检测血清SARSCoV-2 IgM和IgG抗体的敏感性分别为48%和56%,特异性均为100%,胶体金法检测血清SARS-CoV-2 IgM和IgG抗体的敏感性分别为88%和76%,临床特异性均为100%。2种方法检测血清SARS-CoV-2 IgM和IgG抗体总符合率分别为68.9%和73.3%。25例COVID-19患者中有36%的患者血清PCT升高、72%的患者血清CRP升高、84%的患者血清铁蛋白水平升高。结论SARS-CoV-2 IgM和IgG抗体不同检测方法之间差异较大,用于COVID-19患者的临床诊断时应综合考虑。     

非诊断标准抗磷脂抗体的研究进展

正病,主要表现为血管栓塞和病态妊娠,伴有持续抗磷脂抗体阳性。抗磷脂抗体(aPL)是一类异质程度很高,主要以磷脂或磷脂结合蛋白为靶抗原的自身抗体,主要包括抗心磷脂抗体(aCL),抗β2糖蛋白I抗体(β2GPI),狼疮抗凝物(LA)等。2006年悉尼修订的实验室标准中规定,至少在血浆中检测到一种中到高滴度的aPL(LA,IgG或IgM型aCL,IgG或IgM型β2GPI),2次或2次以上并且至少间隔12周。而在实际工作中常会遇到一些病人,临床表现怀疑APS但LA,aCL和β2GPI持续阴性,而对于妇产科来说,早期治疗是预防流产的关键,现有分类     

人细小病毒B19抗体及抗心磷脂抗体(aCL)在流产人群中的检测价值

目的探讨人细小病毒B19抗体及抗心磷脂抗体(aCL)在流产人群中的检测价值,为流产的预防提供理论依据。方法本研究观察对象为2015年1月-2017年1月于我院妇产科就诊的386例自然流产患者以及年龄配对的200例自愿终止妊娠的孕产妇,分别设为观察组与对照组。抽取空腹肘静脉血4ml,离心分析血清后采用酶联免疫吸附试验(ELISA)检测两组孕产妇血清aCLIgG、aCLIgM水平和B19IgG、B19IgM水平,比较两组孕产妇B19IgG、B19IgM、aCLIgG、aCLIgM阳性率以及血清平均水平。结果观察组B19IgG、B19IgM、aCLIgG、aCLIgM阳性率分别为5.08%、41.71%、52.33%、55.44%,对照组分别为6.00%、11.00%、7.00%、7.00%,观察组均显著高于对照组,差异具有统计学意义(P0.05);观察组血清B19IgG、B19IgM、aCLIgG、aCLIgM水平分别为(1.65±0.23)U/mL、(1.76±0.27)U/mL、(4.54±0.23)U/mL、(22.43±3.32)U/mL,对照组分别为(0.67±0.12)U/mL、(0.54±0.15)U/mL、(2.34±0.15)U/mL、(6.51±1.02)U/mL,观察组均显著高于对照组,差异具有统计学意义(P0.05)。结论自然流产孕产妇B19抗体、aCL抗体水平均显著高于正常孕产妇,提示其可能参与孕产妇流产的发生,动态监测B19抗体、aCL抗体水平对自然流产的预防具有十分重要的意义。     

脑出血患者血清弓形虫循环抗原、抗体检测及其临床意义

目的 探讨急性脑出血与弓形虫感染的相关性.方法 采用ELISA方法,对43例急性脑出血及51例对照组血清进行CAg及弓形虫抗体IgM、IgG检测.结果 急性脑出血组CAg、抗体IgM、IgG阳性率分别为23.26%、18.6%、34.88%,对照组阳性率分别为7.84%、5.88%、15.69%,两组间差异显著(P＜0.05).中青年脑出血患者,CAg、IgM阳性率明显高于老年患者.结论 脑出血与弓形虫感染存在相关性,尤其临床无明显诱因的中青年脑出血患者,提示弓形虫急性活动期感染可能是脑出血的病因之一.     

Increased plasma concentrations of antiprothrombin antibodies in women with recurrent spontaneous abortions

BACKGROUND: Antiphospholipid antibodies are associated with recurrent fetal loss, but the clinical relevance of antiprothrombin (aPT) antibodies remains controversial. This study was designed to evaluate the relationship of plasma concentrations of aPT antibodies (IgG, IgM, and IgA isotypes) and recurrent spontaneous abortion (RSA) not associated with antiphospholipid-antibody syndrome. METHODS: In this retrospective case-control study, we measured plasma aPT antibodies in 100 pregnant women at 8-12 weeks of gestation who had histories of recurrent abortion not associated with antiphospholipid-antibody syndrome. The controls were 200 healthy gestational-age-matched women with uncomplicated gestations. RESULTS: The mean (SD) plasma aPT concentrations were significantly (P <0.001) higher in women with histories of recurrent abortion than in healthy controls [7.97 (0.79) and 2.08 (0.07) kU/L]. Similarly, the concentrations of IgM aPT were significantly (P <0.001) higher in patients than in controls [5.73 (0.85) and 1.83 (0.05) kU/L]. No differences were found for IgA aPT (P = 0.358). CONCLUSIONS: High concentrations of aPT antibodies (IgG and IgM isotypes) are associated with pregnancy loss in women with RSA. We suggest that the antibodies may have a relevant role in the etiology and pathogenesis of the condition.     

肺炎衣原体感染与冠心病之间相关性研究的临床意义

目的 探讨肺炎衣原体(Cpn)感染和冠心病的关系.方法 采集200例冠心病患者及100例健康对照者空腹静脉血,采用ELISA法对血浆中Cpn IgM、Cpn IgG进行检测.结果 200例冠心病患者血浆Cpn IgM阳性113例,占56.5%;Cpn IgG阳性145例,占72.5%.100例健康对照组血浆Cpn IgM阳性24例,占24.0%;Cpn ISG阳性43例,占43.0%.冠心病组Cpn IgM、Cpn ISG阳性率均高于健康对照组(P<0.05).结论 冠心病组血浆Cpn IgM、Cpn IgG阳性率高于健康对照组,Cpn与冠心病的发生、发展过程有密切联系.     

肺炎衣原体感染与急性心肌梗死的相关性

目的探讨肺炎衣原体(Cpn)感染与冠心病心肌梗死的关系。方法测定51例急性心肌梗死(AMI)和42例陈旧性心肌梗死(OMI)患者及31例冠脉造影正常者(NC)的Cpn抗体(CpnIgG、CpnIgM)水平及DAN,同时观测C反应蛋白(CRP)、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)]变化。结果AMI组CpnIgG、CpnIgM阳性率及水平高于NC组(P<0.05),CpnDNA检测结果与之吻合。校正冠心病危险因素前、后,CpnIgG阳性与AMI均有相关关系(OR=3.653,P=0.025;OR=3.174,P=0.033)。AMI组中Cpn(+)组CRP、TC、TG、LDLC高于同组中Cpn(-)组(均P<0.05),且IgG与CRP、TC、LDLC呈正相关(P<0.05),调整与CRP相关的冠心病危险因素后,IgG与CRP仍呈正相关;OMI组中Cpn(+)组TG明显高于Cpn(-)组(P<0.05),IgG与TG呈正相关。结论Cpn感染与AMI之间存在明显的相关性,与血脂、CRP也存在相关性。     

冠心病患者肺炎衣原体感染与C反应蛋白、血脂相互关系的研究

目的探讨冠心病（CHD）患者肺炎衣原体（Cpn）感染与C反应蛋白（CRP）、血脂的相互关系,探讨其可能的发病机制。方法采用微量免疫荧光法检测急性心肌梗死（AMI）组、心绞痛（AP）组度对照蛆患者各35例外周血Cpn IgG抗体,同时测定血脂度CRP。结果AMI组、AP组及对照组血清Cpn IgG抗体阳性率分别为82．2％、65．7％及25．7％,AMI蛆、AP组分别与对照组比较差异有统计学意义（均P〈0．01）,但AMI组与AP组间比较差异无统计学意义;血清CRP及血脂总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、我脂蛋白A（apoA）AMI组、AP组显著高于对照组（均P〈0．01）,而高密度脂蛋白胆固醇（HDL-C）AMI组、AP组显著低于对照组（P〈0．01）,AMI组也明显低于AP组（P〈0．01）;Cpn感染者特异性抗体IgG滴度与血中CRP、TG、LDL-C及apoA有明显相关性（r分别为0．44、0．64、0．36和0．32）,而与HDL-C成负相关（r=0．78）（均P〈0．01）。结论CHD患者Cpn感染率明显增高,Cpn可能通过炎症反应及影响脂质代谢在CHD的发生、发展中起作用。     

Diagnostic value of anti-arc 5 IgG antibody and analysis of the IgG subclasses in sera of patients with cystic hydatid disease

Serodiagnosis of cystic hydatid disease (CHD) due to the metacestode of Echinococcus granulosus depends on detecting antibodies specific to hydatid antigen, but cross-reactivity with other parasites is one of the major draw-backs. We used a commercially-available antigen that elicits the arc 5 in immunoelectrophoresis and analysed the immunoglobulin class and the IgG subclass response by an ELISA. We tested sera from patients with confirmed CHD, cystic mass/lesions (CML) of non-hydatid origin, cysticercosis and healthy controls. High levels of antibodies to the hydatid antigen in all three classes (IgG, IgM and IgA) were observed only in the CHD patients. Significantly, only IgG antibody levels were discriminative and of diagnostic value. Also discussed is the validity of reading the significant cut-off point in IgG-ELISA in relation to a clinically important group of patients such as those with a CML of non-hydatid origin rather than healthy controls. Analysis of the anti-arc 5 IgG subclass responses demonstrated high antibody responses in all subclasses among the hydatid patients, with IgG3 the most discriminatory. The significance of the elevation of all four subclasses and more specifically of IgG4 in CHD is discussed in relation to certain biological activities of these immunoglobulin molecules.     

冠心病患者幽门螺杆菌感染与C反应蛋白、血脂相互关系的研究

目的探讨冠心病(CHD)患者幽门螺杆菌(Hp)感染与C反应蛋白(CRP)、血脂的相互关系,探讨其可能的发病机制。方法对2004年3月至2005年1月深圳市罗湖区人民医院心内科收治的70例CHD患者,按临床诊断分为2组,采用酶联免疫吸附试验(ELISA)法检测急性心肌梗死(AMI)组、心绞痛(AP)组及对照组患者各35例外周血Hp抗体(HpIgG),同时测定血脂及CRP。结果AMI组、AP组及对照组血清HpIgG抗体阳性率分别为54.3%、45.7%及25.7%,AMI组、AP组分别与对照组比较差异有统计学意义(P<0.05),但AMI组与AP组间比较差异无统计学意义;血清CRP及血脂总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(apoA)AMI组、AP组显著高于对照组(P<0.01),而高密度脂蛋白胆固醇(HDL-C)AMI组、AP组显著低于对照组(P<0.01),AMI组也明显低于AP组(P<0.01);Hp感染者HpIgG水平与血中CRP、TG、LDL-C及apoA有明显相关性(r分别为0.44、0.64、0.36和0.32),而与HDL-C成负相关(r=-0.78)(P<0.01)。结论CHD患者Hp感染率明显增高,Hp可能通过炎症反应及影响脂质代谢在CHD的发生、发展中起作用。     

Antibody responses to immunization of patients with hemophilia with and without evidence of human immunodeficiency virus (human T-lymphotropic virus type III) infection

Antibody responses after immunization with 23-valent pneumococcal polysaccharide and trivalent influenza virus vaccines were evaluated in 30 adults with hemophilia and in 17 healthy controls. The 30 patients with hemophilia included 13 who were human immunodeficiency virus (HIV) antibody positive with acquired immune deficiency syndrome (AIDS) or AIDS-related complex (group 1), 11 who were asymptomatic HIV antibody positive (group 2), and six who were asymptomatic HIV antibody negative (group 3). Sera were obtained before and 4 weeks after immunization, and levels of antibody were measured by enzyme-linked immunoassay or by hemagglutination inhibition assay. All three groups of patients with hemophilia showed significantly higher preimmunization geometric mean titers of antibodies (groups 1 and 2, fivefold, group 3, 2.8-fold higher), with little increase after pneumococcal vaccine, when compared with controls. Defective humoral responses were noted in groups 1 and 2, with depressed antibody responses after influenza vaccine, significantly elevated levels of IgG and IgM, and depressed blastogenic responsiveness to pokeweed mitogen. Group 3 demonstrated normal responses to pokeweed mitogen, normal antibody responses to influenza vaccine, and normal level of IgG and IgM, although levels of IgG and IgM were higher than those of controls. These data suggest that humoral immune abnormalities are found frequently in patients with hemophilia who are HIV antibody positive. Further, prolonged administration of blood products, regardless of the recipient's HIV status, appears to be associated with polyclonal activation of B cells for T-independent but not T-dependent antigens.     

IFA和ELISA在肿瘤患者血清SARS-CoV抗体测定中的对比分析

目的探讨酶联免疫吸附试验(ELISA)和间接免疫荧光法(IFA)检测严重急性呼吸综合征(SARS)冠状病毒(SARS-CoY)&体在SARS病原中诊断中的特异性及其在肿瘤患者血清中的假阳性问题。方法 应用ELISA和IFA检测了111例正常对照和40例肿瘤患者血清中SARS-CoV抗体的阳性率。结果在111例正常对照和40例肿瘤患者中,IgM抗体均阴性,IgG抗体在正常对照中的阳性率为3.6%(4/111),在肿瘤患者中的阳性率17.5％(7/40),IgC抗体诊断SARS的特异性为96.4％,两种抗体同时阳性诊断SARS的特异性为100％。经IFA检测,上述SARS-CoV抗体阳性者均为阴性。结论 IFA诊断SARS的特异性为100％,ELISA诊断SARS存在一定的假阳性。应用ELISA测定SARS-CoV抗体时,应同时测定两种抗体以降低诊断的假阳性率,提高诊断的特异性。     

Assessment of platelet antibody by flow cytometric and ELISA techniques: a comparison study

Two different methods for evaluating platelet antibody were used to study 12 normal subjects and 24 patients consisting primarily of intravenous drug users (IVDUs) who were positive for human immunodeficiency virus (HIV). Total platelet-associated immunoglobulin G (IgG) and immunoglobulin M (IgM) were measured by enzyme-lined immunosorbent assay on platelet lysate, and platelet surface-associated IgG and IgM were measured by semiquantitative flow cytometry. IgG and IgM values showed significant correlations between the two measurement methods. Mean platelet surface IgG and total IgG were 3.6 and 4.3 times greater, respectively, in IVDUs than in controls, and platelet IgM was also significantly higher in IVDUs than in controls as measured by both techniques. Although mean platelet immunoglobulin levels were higher in the IVDUs with thrombocytopenia than in IVDUs with normal platelet counts, these differences did not achieve significance. These data show that platelet IgG and IgM levels are increased in IVDU-associated HIV infection and suggest that these increases are not confined to patients manifesting thrombocytopenia. The herein described platelet surface antibody and total platelet antibody measurements appear to be equally useful in studying this patient population. Specific details for generating platelet-associated immunofluorescence units are discussed.     

急性心肌梗死患者血肺炎衣原体感染的检测

目的研究肺炎衣原体感染与急性心肌梗死(AMI)的关系。方法应用间接微量免疫荧光法测定42例急性心肌梗死(病例组)患者,72例健康人(对照组)血清肺炎衣原体特异性IgG、IgM抗体滴度。结果对照组、病例组肺炎衣原体总感染率分别为30.6%,88.1%,其中既往感染率分别为30.6%,71.4%,急性感染率分别为0%,16.7%。总感染率、既往感染率及急性感染率在病例组明显增高(优势比分别为16.82%,5.68%,14.2%;95%可信区间分别为5.83~48.54,2.46~13.11,1.68~119.97);与对照组比较病例组血清肺炎衣原体IgG抗体平均几何滴度有非常显著性差异(P<0.01),IgM抗体病例组仅2例阳性,对照组无一例阳性。结论研究结果表明急性心肌梗死肺炎衣原体感染率及血清肺炎衣原体平均几何滴度均较高,肺炎衣原体感染可能是构成急性心肌梗塞发生发展的一个危险因子。