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1.
目的评估抗β2糖蛋白I抗体(antiβ2 glycoproteinⅠ,aβ2GPI)与自身免疫性溶血性贫血(autoimmune hemolytic anemia,AIHA)临床结局的相关性。方法连续收集2008年12月至2013年4月在福建医科大学附属第一医院血液风湿科门诊和病房诊治的AIHA患者,包括继发于SLE的AIHA患者(SLE-AIHA组)和原发性AIHA患者(原发性AIHA组)。检测所有患者Ig G类抗β2GPI。采用SPSS11.5软件统计分析。结果共纳入AIHA患者42例,SLE-AIHA组22例,原发性AIHA组20例。SLE-AIHA组Ig G类抗β2GPI阳性患者溶血达部分缓解所需时间显著长于该抗体阴性患者,差异有统计学意义[(18±7)d vs.(13±4)d,P0.05]。原发性AIHA组Ig G类抗β2GPI阳性组和阴性组患者溶血达部分缓解所需时间无统计学差异[(15±5)d vs.(11±3)d,P0.05]。结论 Ig G类抗β2GPI可能是影响SLE并发AIHA预后的因素之一。  相似文献   

2.
目的:研究针对不同靶抗原的抗磷脂抗体与系统性红斑狼疮(SLE)合并肺动脉高压(PAH)的相关性。方法:收集72例SLE合并PAH(SLE-PAH)患者血清,固相酶联免疫吸附试验(ELISA)法检测血清抗心磷脂(ACL)抗体、抗β2糖蛋白Ⅰ抗体(抗β2-GPI)、抗凝血酶抗体、抗纤溶酶抗体、抗活化蛋白C抗体(抗APC)和抗组织型纤溶酶原激活物抗体(抗t-PA),以128例肺动脉压力正常SLE(SLE-non-PAH)患者血清作为对照。结果:与SLE-non-PAH组相比,IgG型ACL抗体、抗β2-GPI抗体、抗纤溶酶抗体和抗凝血酶抗体阳性率在SLE-PAH组较高,两组间差异有统计学意义;抗APC抗体和抗t-PA抗体的检出率两组差异无统计学意义;重度SLE-PAH患者[肺动脉收缩压(PASP)≥60mmHg]的IgG型抗纤溶酶抗体阳性率较轻中度SLE-PAH患者(PASP〈60mmHg)高,两组间差异有统计学意义(P〈0.01);SLE-PAH组和SLE-non-PAH组相比,各抗体IgM型差异无统计学意义。结论:IgG型抗心磷脂抗体、抗β2-GPI抗体、抗纤溶酶抗体和抗凝血酶抗体与SLE患者发生肺动脉高压相关。  相似文献   

3.
目的探讨原发性肾小球疾病中抗磷脂抗体(APA)及各亚型表达情况。方法选取2015年6月至2017年7月,在浙江大学医学院附属第一医院肾脏病中心行肾穿刺活检,并确诊为原发性肾小球疾病的患者1021例(包括膜性肾病303例,IgA肾病483例,系膜增生性肾小球肾炎76例,微小病变肾病119例,局灶性节段性肾小球硬化40例),检测抗心磷脂抗体(ACL)不同亚型(IgG、IgM和IgA型)和抗β2糖蛋白1(β2GP1)抗体不同亚型(IgG、IgM和IgA型),并进行比较。结果膜性肾病组APA阳性率最高为17.5%,微小病变型肾病组最低为11.8%,组间比较差异无统计学意义。IgA肾病和系膜增生性肾小球肾炎ACL阳性率分别为11.4%和14.5%,均显著高于抗β2GP1抗体阳性率(P0.001,P=0.009);膜性肾病组抗β2GP1抗体阳性率为11.2%,与ACL阳性比差异无统计学意义,但显著高于其余4组患者。系膜增生性肾小球肾炎组ACL-IgM阳性率为13.2%,明显高于其余4组(P0.05)。IgA肾病组ACL-IgA阳性率为5.8%,明显高于其余4组,差异有统计学意义(P0.05)。结论原发性肾小球疾病患者中存在抗磷脂抗体阳性,其亚型在不同病理类型肾炎患者中阳性率差异有统计学意义,可有助于疾病鉴别诊断以及治疗。  相似文献   

4.
目的 探讨系统性红斑狼疮(SLE)合并自身免疫性溶血性贫血(AIHA)患者的临床及血清学特点.方法 收集SLE患者222例,其中发生AIHA的患者17例,应用简单随机抽样法抽取未发生AIHA的34例SLE患者作为对照.回顾性分析患者的一般情况、临床表现、实验室及辅助检查等.计最资料采用t检验,计数资料采用x2检验.结果 SLE合并AIHA的发生率为7.6%.AIHA组抗心磷脂抗体IgG的阳性率(71%)与对照组(15%)相比明显升高(x2=15.366,P<0.01),但2组抗磷脂抗体综合征的发生率差异无统计学意义(x2=0.000,P=1.000).AIHA组关节炎(12%,x2=4.554,P=0.033)、面部红斑(6%,x2=4.443,P=0.033)、白细胞减低(12%,x2=8.061,P=0.005)及淋巴细胞减低(41%,x2=5.075,P=0.024)的发生率较对照组低,差异有统计学意义.AIHA组有3例在病程中出现了肺泡出血,而对照组患者均未出现肺泡出血(x2=3.586,P=0.058).结论 SLE合并AIHA患者的抗心磷脂抗体IgG阳性率高,但抗磷脂抗体综合征的发生率无显著增加.SLE合并AIHA患者关节炎、面部红斑、白细胞减低及淋巴细胞减低的发生率低,但有发生肺泡出血的倾向.  相似文献   

5.
目的 研究抗心磷脂抗体(ACA)及抗β2糖蛋白Ⅰ抗体(aβ,CPI)对系统性红斑狼疮(SLE)患者发生血栓并发症的预测价值.方法 对河北医科大学第二医院免疫风湿科2004年10月至2006年10月收治的45例活动期SLE患者用酶联免疫吸附法(ELIsA)检测ACA及aβ2GPI水平.分析它们与SLE患者血栓发生率的关系.结果 45例SLE患者中27例(60.0%)ACA阳性;其中10例并发血栓;ACA阴性的18例患者中1例并发血栓.ACA 阳性与阴性的SLE患者间血栓发生率差异有统计学意义(P<0.05).ACA对预测SLE患者发生血栓的敏感性为90%,特异性为50%.45例患者中17例(37.8%)aβ2GPI阳性,其中8例并发血栓;aβ2GPI阴性的28例患者中3例并发血栓.aβ2GPI阳性与阴性的SLE患者闻的血栓发生率差异有统计学意义(P<0.01).aβ2CPI预测SLE患者发生血栓的敏感性为72.7%,特异性为73.5%.结论 ACA、aβ2CPI均与LE的血栓形成相关,可用于预测SLE患者的血栓前状态.且aβ2CPI的特异性优于ACA,而敏感性不及ACA.  相似文献   

6.
目的探讨抗β_2糖蛋白Ⅰ(anti-β_2-glycoprotein I,aβ_2GPI)抗体IgA、IgM、IgG在系统性红斑狼疮(systemic lupus erythematosus,SLE)血栓形成中的作用。方法收集确诊SLE患者,根据有无发生临床血栓事件分为SLE-non-APS组和SLE-APS组。选取原发性抗磷脂抗体综合征为PAPS组。这些患者均经实验室检测为aβ_2GP I抗体阳性,且排除血栓形成的传统危险因素。应用酶联免疫吸附试验检测各组患者aβ_2GPI的IgA、IgM、IgG 3类抗体水平。SLE-APS组+PAPS组患者中发生动脉血栓事件者纳入APS-A组,发生静脉血栓事件者纳入APS-V组,比较两组间上述指标。结果共纳入82例患者,SLE患者64例,原发性APS患者18例(PAPS组)。64例SLE患者中,SLE-non-APS组52例,SLE-APS组12例。SLEAPS组+PAPS组共30例,其中APS-A组23例,APS-V组7例。SLE-APS组aβ_2GPI-IgA[(1.3±0.4)×10~(-8)mol/L]、aβ_2GPI-IgM浓度[(1.0±0.2)×10~(-8)mol/L]低于SLE-non-APS组[aβ_2GPI-IgA:(1.8±0.9)×10~(-8)mol/L,aβ_2GPI-IgM:(1.5±0.7)×10~(-8)mol/L](P0.05),而两组aβ_2GPI-IgG的浓度无明显差异。SLE-APS组与PAPS组患者aβ_2GPI-IgA、aβ_2GPI-IgG、aβ_2GPI-IgM的浓度无明显差异。APS-A组aβ_2GPI-IgM浓度[(1.2±0.5)×10~(-8)mol/L]显著高于APS-V组[(0.7±0.1)×10~(-8)mol/L](P0.05),aβ_2GPI-IgG浓度显著低于APS-V组[(1.4±0.3)×10~(-8)mol/L vs.(1.7±0.3)×10~(-8)mol/L](P0.05),而两组aβ_2GPI-IgA的浓度无明显差异。结论无论有无SLE基础免疫性疾病,IgG类aβ_2GPI与静脉血栓形成有明显的关联性,IgM类aβ_2GPI与动脉血栓形成相关。  相似文献   

7.
目的 探讨抗心磷脂抗体在系统性红斑狼疮(SLE)高血压患者中的临床意义.方法 应用酶联免疫吸附法(ELISA)检测110例SLE患者和50名健康者血清中抗心磷脂抗体IgG(IgG-ACA)、抗心磷脂抗体IgM(IgM-ACA)、抗β2糖蛋白I(β2-GP1)抗体的浓度水平.结果 SLE高血压组IgG-ACA、IgM-ACA、抗β2-GP1抗体浓度水平高于SLE正常血压组、健康对照组(P<0.05),而SLE正常血压组与健康对照组比较差异无统计学意义(P>0.05).结论 SLE患者合并高血压时IgG-ACA、IgM-ACA、抗β2-GP1抗体浓度水平升高,提示ACA升高与狼疮性高血压的发生有关,抗心磷脂抗体检测对预测狼疮性高血压有一定参考价值.  相似文献   

8.
目的 评估肾小球微血栓(GMT)在狼疮肾炎(LN)中的发生率,并探讨针对某些凝血相关因子的抗体和抗磷脂抗体在LN患者GMT形成中的临床意义.方法 连续收集124例LN患者肾活检组织标本和血浆,观察组织标本中GMT的发生率.并分成LN-GMT组和LN-non-GMT组;比较两组患者的疾病活动度、相关实验室检查指标和肾组织活动,慢性指数;测定患者的狼疮抗凝物(LA)、抗心磷脂抗体(ACL)、抗β2糖蛋白I(抗β2GP I)抗体、抗凝血酶抗体、抗纤溶酶抗体、抗组织型纤溶酶原激活物(t-PA)抗体和抗膜联蛋白AⅡ(Annexin A II)抗体.结果 GMT在LN中的发生率约为20.2%;LN-GMT组系统性红斑狼疮疾病活动指数(SLEDAI)、肾组织病变活动指数、肾组织病变慢性指数、尿蛋白定量(24 h)、血清肌酐、血清尿素氮的水平和高血压的发生率都较LN-non-GMT组高(P<0.01);LN-GMT组LA、IgG型抗B2GP I抗体和抗凝血酶抗体阳性率均显著高于LN-non-GMT组(P<0.05);两组IgG型ACL抗体、抗纤溶酶抗体、抗t-PA抗体和抗Annexin A II抗体阳性率差异均无统计学意义(P>0.05);两组各抗体IgM型差异无统计学意义(P>0.05).结论 LN中伴有GMT形成的患者肾脏病变重于无GMT者;LA、IgG型抗β2GP I抗体和抗凝血酶抗体与LN患者GMT形成相关.  相似文献   

9.
目的 了解海南地区消化道恶性肿瘤患者血清抗弓形虫抗体水平,为消化道恶性肿瘤患者弓形虫病防控提供参考依据。方法 2016–2019年收集海南省1 932例消化道恶性肿瘤患者作为调查对象,其中食管癌患者376例、胃癌患者475例、结直肠癌患者401例、肝癌患者427例、胰腺癌患者253例,以400例健康体检者作为对照。采用酶联免疫吸附试验检测消化道恶性肿瘤患者和健康体检者血清抗弓形虫IgG和IgM抗体,比较组间抗体阳性率差异。结果 消化道恶性肿瘤患者总体血清抗弓形虫IgG抗体阳性率为19.82%,显著高于健康对照的3.75%(χ2 = 60.49,P < 0.01),两者总体抗弓形虫IgM抗体阳性率差异无统计学意义(1.09%和0.50%;χ2 = 1.17,P > 0.05)。食管癌、胃癌、结直肠癌、肝癌和胰腺癌患者抗弓形虫IgG抗体阳性率分别为15.16%、19.58%、21.70%、23.65%和17.79%,均显著高于健康对照(χ2 = 29.97、50.29、58.03、67.85、36.59,P均< 0.01);抗弓形虫IgM抗体阳性率分别为1.06%、1.47%、0.75%、1.17%和0.79%,与健康对照差异均无统计学意义(χ2 = 0.80、2.02、0.20、1.11、0.21,P均> 0.05)。不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率差异有统计学意义(χ2 = 10.65,P < 0.05),但抗弓形虫IgM抗体阳性率差异无统计学意义(χ2= 1.33,P > 0.05)。结论  海南地区消化道恶性肿瘤患者血清抗弓形虫IgG抗体阳性率较高,不同类型消化道恶性肿瘤患者抗弓形虫IgG抗体阳性率间存在显著差异。建议今后应加强消化道恶性肿瘤患者弓形虫感染筛查,从而有效防控弓形虫感染对消化道恶性肿瘤患者造成的危害。  相似文献   

10.
目的探讨抗心磷脂抗体在系统性红斑狼疮(SLE)高血压患者中的临床意义。方法应用酶联免疫吸附法(ELISA)检测110例 SLE 患者和50名健康者血清中抗心磷脂抗体 IgG(IgG-ACA)、抗心磷脂抗体 IgM(IgM-ACA)、抗β_2糖蛋白Ⅰ(β_2-GP1)抗体的浓度水平。结果 SLE 高血压组 IgG-ACA、IgM-ACA、抗β_2-GP1抗体浓度水平高于 SLE 正常血压组、健康对照组(P<0.05),而 SLE 正常血压组与健康对照组比较差异无统计学意义(P>0.05)。结论 SLE 患者合并高血压时 IgG-ACA、IgM-ACA、抗β_2- GP1抗体浓度水平升高,提示 ACA 升高与狼疮性高血压的发生有关,抗心磷脂抗体检测对预测狼疮性高血压有一定参考价值。  相似文献   

11.
Objective. To investigate whether anticardiolipin antibodies (aCL) in patients with systemic lupus erythematosus (SLE) bind to β2-glycoprotein I (β2GPI), and to search for a relationship between the presence of IgG and/or IgM anti-β2GPI antibody and clinical manifestations in SLE patients. Methods. IgG and IgM anti-β2GPI in 308 Japanese SLE patients were measured using phospholipid-independent enzyme immunoassays. Relationships to clinical histories and to various laboratory data were examined. Results. The values of anti-β2GPI and aCL, as measured by conventional enzyme immunoassay, showed a strong correlation, but the anti-β2GPI assay was more useful in distinguishing β2GPI-dependent aCL from β2GPI-independent aCL. The presence of IgG anti-β2GPI was associated with an increased frequency of a history of thrombosis. Comparisons of various laboratory data suggested that the titer of anti-β2GPI may fluctuate with disease activity. Conclusion. The results suggest that pathogenic aCL is directed against structurally altered β2GPI and that enzyme immunoassay for anti-β2GPI may prove useful in evaluating the risk of thrombosis and monitoring the clinical course in patients with SLE.  相似文献   

12.
OBJECTIVE: To test the prevalences and the clinical associations of anticardiolipin (aCL) and anti-beta2GPI (abeta2GPI) antibodies in a large series of European patients with systemic lupus erythematosus (SLE). METHODS: 574 SLE patients from 7 European countries were tested for aCL and abeta2GPI by ELISA methods. RESULTS: aCL of IgG, IgM, and IgA isotypes were detected in 22.8%, 14%, and 13.9% of the patients, respectively. IgG and IgM abeta2GPI were detected in 20% of the patients. The presence of aCL was highly associated with the presence of abeta2GPI. Medium-high titer IgG aCL and abeta2GPI were associated with thrombosis, with similar sensitivity, specificity, and positive predictive value. When present at medium-high titer, IgG aCL were associated with thrombocytopenia, IgM aCL with hemolytic anemia, and cerebrovascular accidents. IgA aCL with livedo reticularis and Raynaud's phenomenon. CONCLUSIONS: aCL, when present at medium-high titer, are as important as abeta2GPI, as a risk factor for thrombosis. Medium-high titer aCL, but not abeta2GPI, are associated with other clinical features of the antiphospholipid syndrome.  相似文献   

13.
目的:探讨抗β2糖蛋白I型抗体(抗β2 GPI抗体)与急性冠脉综合征(ACS)的临床相关性。方法:采用酶联免疫吸附法检测168例ACS患者血清中抗β2 GPI抗体的浓度水平,同时进行冠脉造影术检查,并对罪犯血管进行血管重建。根据抗体浓度水平分为高、中、低浓度组,分析各组中抗体浓度与ACS临床分型[急性ST段抬高型心肌梗死(STEMI)、急性非ST段抬高型心肌梗死(NSTEMI)、中危以上不稳定型心绞痛(UA)]的相关性,随访12个月,评价抗β2 GPI抗体浓度与ACS患者的疾病严重程度及主要不良心血管事件(MACEs)的相关性。结果:ACS中STEMI、NSTEMI、UA患者抗β2 GPI抗体浓度依次是(63.4±32.6)RU/ml,(39.8±25.9)RU/ml,(22.1±10.4)RU/ml,其中STEMI患者抗体浓度较高,UA患者的抗体浓度最低。抗β2GPI抗体的高浓度组中STEMI(10/11)占90.9%,高于中浓度组(29/96)和低浓度组(1/61)(P〈0.01)。随访观察12个月,随访率98%;抗β2 GPI抗体高浓度组有4例发生MACEs,发生率36.4%,显著高于中浓度组(4.2%)和低浓度组(3.5%)。多因素回归分析提示抗β2GPI抗体高浓度是预测ACS发生MACEs的独立危险因素之一。结论:抗β2 GPI抗体浓度与ACS患者疾病的严重程度及MACEs密切相关,抗β2 GPI抗体高浓度是ACS再发MACEs的独立危险因素之一。  相似文献   

14.
OBJECTIVE: To investigate whether anticardiolipin (aCL) and anti-beta(2)-glycoprotein I (anti-beta(2)GPI) antibodies are associated with lupus nephritis (group II patients), and whether there are differences in the prevalence of these two autoantibodies between group II patients and patients with non-nephritis SLE (group I) and primary antiphospholipid syndrome (PAPS) patients (group III). METHODS: IgG and IgM aCL were measured in 31 patients and anti-beta(2)GPI in 30 patients with systemic lupus erythematosus (SLE) nephritis and 25 without SLE nephritis and in 36 PAPS patients by validated enzyme immunoassays. Relationships of anti-double-stranded DNA (anti-dsDNA) antibodies and antibodies to the collagenous region of C1q (anti-C1q) with SLE nephritis were also examined. RESULTS: The prevalence and levels were higher for aCL, but not for anti-beta(2)GPI, antibodies in group II than in group I patients. Absolute values of aCL and anti-beta(2)GPI in all three patient groups correlated with each other. The prevalences of aCL, anti-dsDNA and anti-C1q antibodies were significantly higher in group II than in group I and group III patients. CONCLUSION: The observations in this paper suggest that raised levels of aCL antibodies are associated with lupus nephritis. We were not able to demonstrate an association between anti-beta(2)GPI antibodies and kidney disease either in patients with lupus or in patients with primary antiphospholipid syndrome. In SLE, we demonstrated that the presence of anticardiolipin antibodies in conjunction with elevated levels of anti-dsDNA and anti-C1q antibodies is highly specific for glomerulonephritis in patients with lupus.  相似文献   

15.
目的:分析自身免疫性溶血性贫血(AIHA)患者血液中红细胞相关抗体(EAIg)免疫分型的临床意义。方法;采用流式细胞仪和抗人单克隆抗体检测24例AIHA患者的EAIg,并分析其亚型及其与临床的关系。结果:24例AIHA患者直接抗人球蛋白试验(Coombs)仅8例阳性,阴性16例,而FCM检测出其中13例EAIg阳性,类型分布以IgG+C3型多见,且贫血、溶血程度重,余依次为C3型、IgG型。结论:AIHA免疫分型可判定疾病的严重程度以及为临床治疗提供依据。  相似文献   

16.
We studied the prevalence, isotype distribution, and clinical significance of anticardiolipin (aCL) and anti-beta2glycoprotein I (anti-beta2GPI) antibodies in two populations of patients with systemic lupus erythematosus (SLE), 160 Colombians and 160 Spaniards. All sera were tested in our laboratory by enzyme-linked immunosorbent assay (ELISA) for IgG, IgM, and IgA aCL, as well as IgG and IgM anti-beta2GPI. Positive results for at least 1 of the 3 aCL isotypes were found in 40 Colombians (25%) and 55 Spaniards (34%). IgG aCL was the predominant isotype in both populations. Positive results for at least 1 of the anti-beta2GPI isotypes were found in 34 Colombians (21%) and 29 Spaniards (18%). IgG anti-beta2GPI was the dominant isotype in Colombians, while IgM was predominant in Spaniards. Positivity for anti-beta2GPI in aCL-positive patients was present in 77% in the Colombian group and 50% in the Spaniard group. Among Colombians, IgG aCL and anti-beta2GPI correlated with thrombosis, fetal loss, and thrombocytopenia. Among Spaniards, IgG aCL and IgG anti-beta2GPI correlated with thrombosis, fetal loss, and livedo reticularis. For detecting thrombosis and fetal loss, aCL ELISA was more sensitive than anti-beta2GPI in Spaniards, and anti-beta2GPI ELISA was more specific than aCL in both populations.  相似文献   

17.
The presence of both complete IgM autoagglutinins and IgG autoantibodies in warm autoimmune hemolytic anemia (AIHA) is an uncommon finding. Over a 6-year period, only 5 of 115 (4.1%) patients with AIHA had IgM and IgG autoantibodies. In 3 of the 5 cases, the complete IgM autoagglutinins reacted up to 30 degrees C and these patients responded well to corticosteroid or other therapies for warm AIHA. The 2 patients who had warm (37 degrees C) reactive IgM autoagglutinins, were refractory to corticosteroids, splenectomy and cytotoxic drugs, and died due to the complications of hemolytic anemia. The data in these 5 cases suggest that the thermal amplitude of the IgM antibody in these unusual AIHA cases may be predictive of refractoriness to therapy and poor clinical outcome.  相似文献   

18.
Anaemia is a common hematological abnormality in systemic lupus erythematosus (SLE). Autoimmune hemolytic anaemia (AHA) is one of the types of anaemia in SLE. Other reasons of anaemia in SLE are: chronic inflammatory diseases, insufficient level of elements necessary for erythropoiesis and chronic renal disease. The aim of the study was to examine the relations between severity of anemia and presence of certain antiphospholipid antibodies (aPL) in SLE. The study group consisted of 24 patients (one man and 23 women) with active lupus. Anticardiolipin antibodies (aCL), anti-02 glycoprotein I antibodies (anti-beta2 GPI IgM and IgG) and red cell parameters: haemoglobin level (Hb), erythrocytes (RBC), mean corpuscular volume (MCV), mean corpuscular haemoglobin mass (MCH), mean corpuscular haemoglobin concentration (MCHC) and ferritin level were measured before beginning or intensification of treatment. The activity of SLE was measured by SLEDAI and C3 complements. The patients were divided into two subgroups: subgroup with aCL-IgG above 20 u/ml and below 20 u/ml. In patients with aCL-IgG above 20 u/ml the mean Hb level was lower, and the mean ferritin level was significantly higher than in patients with aCL-IgG level below 20 u/ml. We observed a negative, significant correlations between Hb and aCL-IgG (p = 0.01; R = -0.47) and between Hb and anti-32 GPI IgG (p = 0,0003; R = -0,67) and a negative correlation between Hb and activity of SLE estimated by SLEDAI (p = 0.02; R = -0.45) and positive between Hb and C3 complement (p = 0.02; R = +0.5). In conclusion: antiphospholipid antibodies presence in patients with SLE can influence the severity of anaemia.  相似文献   

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