抗β2GP1抗体检测方法的建立及临床意义

目的建立抗β２ＧＰ１抗体检测的ＥＬＩＳＡ方法。方法用亲和层析得到的纯化β２ＧＰ１为抗原。结果和结论１１２例被检血清抗β２ＧＰ１及抗心磷脂抗体的检测结果表明，两种方法的检测结果呈正相关（ＩｇＧ类ｒ＝０．６６７，ＩｇＭ类ｒ＝０．５５３）。抗β２ＧＰ１阳性组较阴性组患者血栓／多发性流产的发生率高，抗β２ＧＰ１的检测对血栓／多发性流产的发生有预示价值。为临床建立敏感、特异的诊断方法奠定了基础。     

抗凝血酶原抗体和抗磷脂抗体综合征

凝血酶原属于维生素K依赖性凝血因子。抗磷脂抗体综合征主要表现为血栓和反复流产。低亲和力的抗凝血酶原抗体与抗磷脂抗体综合征存在一定的联系。抗凝血酶原抗体检测标准化将有助于抗磷脂抗体综合征的诊断。     

抗凝血酶原抗体和抗磷脂抗体综合征

凝血酶原属于维生素K依赖性凝血因子。抗磷脂抗体综合征主要表现为血栓和反复流产。低亲和力的抗凝血酶原抗体与抗磷脂抗体综合征存在一定的联系。抗凝血酶原抗体检测标准化将有助于抗磷脂抗体综合征的诊断     

抗心磷脂抗体检测和抗磷脂抗体综合征诊断

磷脂是指分子中含有醇 ,脂肪酸和磷酸基团的一类化合物。人体内的磷脂主要是含有甘油醇的甘油磷脂 ,包括心磷脂 ,磷脂酰丝氨酸 ,磷脂酰胆固醇 ,磷脂酰乙醇胺等。抗磷脂抗体 (antiphospholipidantibody ,aPL)是一族针对带负电荷磷脂或带负电荷磷脂与蛋白复合物的异质性抗体。抗磷脂抗体综合征 (antiphospholipidsyndrome ,APS) ,是一组与抗磷脂抗体有关的自身免疫性疾病 ,典型的临床表现有动脉血栓 ,静脉血栓以及妊娠丢失。APS患者血中检出aPL是确立APS诊断的必要条件。根据一些aPL可以识别磷脂或磷脂与蛋白复合物的特性 ,采用心磷脂包…     

育龄期妇女抗心磷脂抗体和抗β2-糖蛋白1抗体检测及临床应用

抗磷脂抗体综合征（ASP）是常见的疾病,易引起习惯性流产、早产、死胎等症状.临床上,依赖病人表现和磷脂抗体（aPL）来确诊.aPL有多种,其中最重要、最具代表性的aPL是抗心磷脂抗体（aCL）和抗β2-糖蛋白1 （β2-GP1）抗体.……     

抗内皮细胞抗体的检测及临床应用

目的 建立可以常规应用的免疫荧光法检测血清中抗内皮细胞抗体（AECA）。方法 对试验条件进行研究并与ELISA法对比，检测冠心病、脑梗死、肺疾患及脑血管障碍患者310例，青年健康组50例，老年健康组30例。结果 两法检测阳性率无显著差异（P＞0．05），符合率89．7％；试验表明，用两种方法检测冠心病组、脑梗死组的AECA阳性率均明显高于健康组（P＜0．01），肺疾患组与脑血管障碍组也高于健康组（P＜0．05），内皮素检测证实AECA阳性者与内皮素升高明显正相关。结论 自身免疫形成的AECA在促进内皮细胞损伤中具有重要意义；免疫荧光法快速、简便，适用于临床应用。     

检测抗精子抗体的临床应用

目的了解抗精子抗体致免疫性不孕及反复流产的重要性。方法收集325例原、继发性不孕和反复流产妇女血清标本做实验组,同时收集156例正常孕妇的血清标本做对照组,用酶联免疫法(ELISA)分别检测其抗精子抗体(AsAb)。结果实验组AsAb阳性率为13.5%,对照组AsAb阳性率为1.3%,经卡方检验:X2=18.3、P<0.01,显示两组人群AsAb的阳性率差异有显著性。结论AsAb可导致免疫性不孕及流产。     

快速检测不完全抗体方法的临床应用

我们在文献（林妈利．输血医学．台北：立正黑白制版有限公司，1992：188）提出的手工凝聚胺试验技术的基础上，通过实验改良，研制了一种组合试剂，快速检测不完全抗体，并作为常规技术用于临床，现将应用情况报告如下：1材料与方法1·1血型抗体红细胞请细胞，抗人球蛋白血清，菠萝员均购自成都中国医学科学院输血研究所．1．2组合试剂A液参照文献[1]，B液称取硫酸鱼精蛋白0．25g，血清白蛋白1．25g，聚乙二醇（分子量6000）1.25g加入灭菌蒸馏水250ml；C液称取柠檬酸三钠2．5g加入灭菌蒸馏水250ml。1．3方法取待检血清2滴，加人洗涤三次…     

抗磷脂抗体综合征的实验与临床

抗磷脂抗体（antiphospholipid antibody,APA）的本质仍不清楚,但大多学认为是一组酸性磷脂的异质性自身抗体的总称.它包括狼疮抗凝因子（lupus anticoagulant,LA）、抗心磷脂抗体（anticardiolipin antibodies,ACA）两大类,抗磷脂酸抗体、抗磷脂酰丝氨酸抗体、抗磷脂酰乙醇胺抗体、抗磷脂酰胆碱抗体、抗磷脂酰肌醇抗体等均可归于这两大类中.     

儿童肾病综合征D—二聚体、抗凝血酶与抗心磷脂抗体的检测

目的探讨儿童肾病综合征 (NS)止凝血改变。方法测定 38例 NS儿童及 2 0名正常儿童的 D-二聚体、抗凝血酶活性 (AT- :A)与抗心磷脂抗体 (ACA )的含量。结果初诊为 NS的小儿 D-二聚体显著高于正常对照组(0 .44 9± 0 .195 ,P<0 .0 1) ;抗凝血酶活性显著下降 (85 .40± 14.0 6 ,P<0 .0 1) ,其中 5例下降到 70 %以下 ;ACA12例阳性 ,阳性率为 31.6 %。结论 NS患儿存在着抗凝作用减弱 ,纤溶活性增高。同时检测 D-二聚体、抗凝血酶活性与 ACA能较好地反映 NS患儿的血栓形成状况。     

An immunochemical method for quantitative determination of latent antithrombin, the reactive center loop-inserted uncleaved form of antithrombin

Antithrombin (AT) is a serine protease inhibitor that has thrombin, factors IXa and Xa as target proteases. In addition to active native AT, two other forms have been identified in plasma: the reactive center loop inserted cleaved and latent, uncleaved forms. Both have been shown to be present in normal human blood. Latent AT forms a dimer with native AT in vitro, thus inactivating the native form. Here we describe a mouse monoclonal antibody, 8C8, that is specific for latent AT. The affinity of 8C8 was found to be 500-fold higher for latent than for native AT and 5000-fold higher for latent than for cleaved AT. A sandwich assay was developed to measure the concentration of latent AT in plasma, which was found to be approximately 4.8 mg L(-1) in healthy individuals. The K(D) of the interaction between native and latent AT was found to be 51 mum, i.e. far above the plasma concentration of both native and latent AT, indicating a negligible complex formation in blood.     

Pharmacology and clinical applications of human recombinant antithrombin

Importance of the field: Antithrombin therapy (AT) has been tested in various medical applications. With advances in genetics and biotechnology, large-scale production of human recombinant antithrombin (rhAT) is now feasible. The prospect of administering a recombinant protein rather than a pooled blood component, has rekindled interest in antithrombin therapy. However, many known properties of human pooled antithrombin (hpAT) still need to be investigated and established for rhAT.

Areas covered in this review: The manufacture and clinical pharmacology of antithrombin. The literature, evidence and our own views about the future of this drug and its potential clinical applications.

What the reader will gain: The reader will appreciate the biological rationale underpinning antithrombin administration in various clinical settings. The potential benefits and harms of the intervention are addressed. Novel future applications of recombinant antithrombin are broached.

Take home message: rhAT has been approved for its use in congenital antithrombin deficiency. rhAT has also been used off-label to treat heparin-resistance in cardiac surgery and sepsis. It is a promising adjuvant for immunosuppression in organ transplantation, and may have role as an anti-angiogenic, anti-tumor and anti-viral agent. rhAT has clear safety advantages over phAT, such as the avoidance of infection transmission.     

The cleaved and latent forms of antithrombin are normal constituents of blood plasma: a quantitative method to measure cleaved antithrombin

Antithrombin (AT), a member of the serine protease inhibitor family, is the key regulator of thrombin activity in vivo. Thrombin inhibition is accomplished by the formation of covalent thrombin-AT (TAT) complex. The rate of inhibition is accelerated by heparin, which also leads to the formation of a substantial amount of cleaved AT. We produced a murine monoclonal antibody (mAb) (M9) that is specific for the two forms of AT, in which the reactive center loop is inserted into beta-sheet A, i.e. cleaved and latent AT. The antibody has no measurable affinity for native AT. Using M9 as a catcher antibody in conjunction with a mAb (M27) that does not bind latent AT, we developed a sandwich assay that measures cleaved AT without interference from latent and native AT. The concentration in healthy subjects was determined to be 1.3 mg L(-1) (range: 1.0-1.9), which was about 100-fold lower than the plasma concentration of native AT and 1000-fold higher than the concentration of the TAT complex. The cleaved AT concentration is higher than what would be expected from the rate of formation of cleaved AT in vitro in conjunction with TAT complex formation in the presence of heparin. The concentration of cleaved AT did not correlate with the TAT concentration in plasma from patients with venous thrombosis.     

Low borderline plasma levels of antithrombin,protein C and protein S are risk factors for venous thromboembolism

Summary. Background: Inherited deficiencies of antithrombin (AT), protein C (PC) and protein S (PS) are risk factors for venous thromboembolism (VTE). They are usually defined by laboratory cut‐offs (in our setting 81, 70 and 63 IU dL^?1, respectively), which give only a rough idea of the VTE risk associated with plasma levels of these proteins. Objectives: We investigated whether the risk of VTE associated with the plasma deficiencies of AT, PC or PS has a dose–response effect, and whether low borderline levels of these proteins are associated with an increased risk of VTE, both in the whole study population and separately in carriers of either factor V Leiden or G20210A prothrombin gene mutation. Patients/Methods: A case–control study of 1401 patients with a first objectively‐documented VTE and 1847 healthy controls has been carried out. Results: A dose–response effect on the VTE risk was observed for all the three anticoagulant proteins. Compared with individuals with AT, PC or PS levels > 100 IU/dL, the adjusted odds ratio (95%CI) of VTE was 2.00 (1.44–2.78) for AT levels between 76 and 85 IUdL^?1, 2.21 (1.54–3.18) and 1.84 (1.31–2.59) for PC and PS levels between 61 and 75 IUdL^?1. The risk of unprovoked VTE in factor V Leiden or prothrombin G20210A carriers appears 2 to 3‐fold increased when levels of AT or PS are low borderline. Conclusions: Low borderline plasma levels of AT, PC and PS are associated with a 2‐fold increased risk of VTE and should be considered in the assessment of the individual VTE risk.     

凝血检查在抗磷脂综合征中的应用

目的了解凝血指标与抗磷脂综合征（APS）的相关性,评价其在APS诊断与监测中的价值。方法收集疑似APS患者共155例,根据2006年最新修正的APS诊断标准判别APS患者41例,非APS患者114例,检测所有患者的D-二聚体（DD）、抗凝血酶（AT）、纤溶酶原（PLG）、血小板（PLT）计数、稀释凝血酶原时间（dPT）等凝血指标,分析其与APS的相关性。结果APS患者与非APS患者间AT、PLG、PLT水平差异无统计学意义（P〉0．05）,DD水平差异有统计学意义（P〈0．05）,狼疮抗凝物（LA）阳性的APS患者与非APS患者间dPT阳性率差异有统计学意义（P〈0．05）。结论DD水平及dPT结果与APS具有相关性,有助于临床上APS血栓形成的评价。     

抗磷脂综合征合并静脉血栓和蛋白C活性异常1例研究报告

目的：探讨抗磷脂综合征（antiphospholipid syndrome，APS）患者静脉血栓形成的原因。方法：对1例APS患者用发色底物法测定蛋白C活性（PC：A）、蛋白S活性（PS：A）和抗凝血酶活性；用ELISA方法测定PC、血浆纤溶酶原、血浆组织型纤溶酶原激活物、血浆纤溶酶原激活抑制物-1、α2-抗纤溶酶抗原和抗心磷脂抗体（ACA）。活化蛋白C抵抗（APC—R）检测结果以受检者血浆加入APC后的APTT与未加APC血浆的APTT的比值表示，比值〈2．0时为APC-R阳性。狼疮抗凝物质（LA）检测使用以dRVVT为基础的商品化试剂盒。采用PCR扩增和直接测序，检测PC的基因及FVLeiden和凝血酶原G20210A的突变。结果：本例患者LA和APC—R阳性，PC：A降低，PC抗原量增加，其他结果正常．PC基因所有外显子测字结果正常，FVLeiden突变和凝血酶原G20210A突变未检出。结论：LA可能通过抑制PC途径导致患者发生血栓，联合检测ACA、APC-R、抗凝蛋白抗原及活性有利于血栓性疾病的病因学诊断。     

抗磷脂综合征发病机制及诊治进展

抗磷脂综合征(antiphospholipid syndrome,APS)主要表现为血栓形成或病态妊娠,实验室检测抗磷脂抗体(an-tiphospholipid antibody,APL)阳性,如抗心磷脂抗体(anticardiolipin antibody,ACA)、抗β2-糖蛋白1(β2-glycoprotein l,β2-GP1)抗体及狼疮抗凝物(lupus anticoagulant,LAC)。β2-GP1及其抗体在APS发病机理中的作用日益受到人们的重视。APS累及全身多个系统,治疗上除肝素、华法林和阿司匹林外,还可试用免疫抑制剂、大剂量丙种球蛋白等,其他与发病机制相关的免疫治疗仍在进一步研究中。     

抗磷脂综合征临床特征分析

目的探讨抗磷脂综合征（APS）的临床特征和实验室检查特点。方法回顾性分析总结2009年1月-2012年1月26例APS患者的临床表现和实验室检查。结果患者共26例,男8例,女18例。原发性APS7例,继发性APS19例,其中继发系统性红斑狼疮11例。21例血栓形成患者中静脉血栓16例,动脉闭塞7例,其中静脉血栓和动脉闭塞同时存在2例。血栓事件以下肢深静脉血栓、脑梗死为常见。在16例已婚女性中7例出现病态妊娠,4例为习惯性自发性流产。57．7％患者出现血小板下降,69．2％患者不同程度血红蛋白下降。结论APS以血栓形成及病态妊娠为特点。其临床表现具有多样性。早期诊治是改善预后的关键。     

系统性红斑狼疮合并抗磷脂综合征患者的临床分析

目的 研究系统性红斑狼疮合并抗磷脂综合征(SLE-APS)患者的临床特点.方法 对39例SLE-APS患者的临床和实验室资料进行回顾性分析.结果 39例患者中,有31例共发生了48次血栓栓塞事件,以深静脉血栓及脑梗死为主.26例已婚有生育史女性患者中,有12例发生病态妊娠.28例抗心磷脂抗体阳性;16例狼疮抗凝物阳性.24例患者先确诊SLE,平均9.5年后又出现APS样表现;12例先出现反复病态妊娠或血栓事件,平均4.8年后演变为SLE;3例一发病便同时符合SLE和APS的分类标准.有5例在发生血栓事件或病态妊娠时的狼疮活动指数<5分.结论 SLE-APS患者血栓事件及病态妊娠发生率增多.APS可出现于SLE之前、之后或同时.狼疮患者可以在病情稳定期出现APS的表现.详细询问病史、常规检测抗心磷脂抗体,有助于发现SLE-APS的高危因素,积极预防APS的发生.