系统性红斑狼疮D-二聚体、抗心磷脂抗体检测的临床意义

目的 探讨系统性红斑狼疮（SLE）患者血浆中D-二聚体水平变化及其临床意义.方法 采用ELISA法检测46例活动期SLE患者（研究组）血浆D-二聚体水平,并与缓解期患者和20名健康对照组比较,对研究组的40例SLE患者进行抗心磷脂抗体（ACA）检测.结果 SLE患者血浆D-二聚体水平检测结果,活动期患者明显高于稳定期患者及健康对照组（P 〈 0.01）,并且与SLAM得分呈正相关（r = 0.530,P 〈 0.01）;缓解期患者与对照组差异无统计学意义（P 〉 0.05）;伴有和不伴有血栓形成患者差异有统计学意义（P 〈 0.05）,40例SLE患者ACA阳性率为55.0%,ACA阳性和阴性患者血浆D-二聚体水平差异有统计学意义（P 〈 0.05）,伴有和不伴有血栓形成SLE患者ACA阳性率比较差异有高度统计学意义（P 〈 0.01）.结论 SLE患者血浆中D-二聚体水平能够反应疾病活跃性,联合ACA阳性率检测可判断SLE患者血液高凝与纤溶状态,并且可作为SLE患者并发血栓形成趋势的判断指标.

Clinical significance of detecting systemic lupus erythematosus D-dimer and Anti cardiolipin antibody

Objective To study the clinical significance and D-dimer levels changing of systemic lupus erythematosus in plasma of patients. Methods Forty six active patients in the treatment group with SLE used ELISA to be detected, compared the level of D-dimer in plasma with the remission and 20 healthy cases in the control group, 40 cases with SLE in the treatment group underwent ACA detection. Results The detection result of D-dimer in plasma of the pa- tients, active patients were higher than the stable patients and the healthy people in the control group （P 〈 0.01）, and the SLEDAI was positive correlation （r = 0.530, P 〈 0.01）; The difference between patients in remission and the control group was not statistically significant （P 〉 0.05）; The difference between the patients with thrombosis and those without thrombosis was statistically significant （P 〈 0.05）, the positive rate of 40 SLE patients with ACA was 55.0%, the difference in plasma D-dimer level between the patients with ACA positive and negative was statistical signifi- cance （P 〈 0.05）, compared the positive rate of 40 SLE patients with ACA was significant different （P 〈 0.01）. Con- clusion The disease activity can be responsed on the level in plasma D-dimer of the patients with SLE, the patients＂ high blood coagulation and fibrinolysis state of the patients with SLE can be judged with the ACA detection positive rate, and can be used as judgement index of the trend of SLE patients complicated with thrombosis.