系统性红斑狼疮患者血清AECA检测临床意义的再评价

目的 采用Meta分析方法 评价系统性红斑狼疮(SLE)患者血清抗内皮细胞抗体(AECA)阳性率、优势比(OR)及探讨阳性率异质性的来源.方法 计算机联合手工规范检索建库至2020年8月1日中国学术期刊全文数据库、万方数据库、维普数据库、中国生物医学文献数据库、PubMed和Embase数据库中符合研究目的的中英文文献...

Reevaluation of the clinical significance of serum AECA in patients with systemic lupus erythematosus

Objective To evaluate the positive rate of serum anti-endothelial cell antibody(AECA)and odds ratio(OR)in patients with systemic lupus erythematosus(SLE)using Meta analysis method and to investigate the source of the heterogeneity of positive rate.Methods The Chinese and English literatures meeting the research purpose in CNKI,Wanfang,VIP,CBM,PubMed and Embase databases from the establishment of the database to August 1,2020 were searched by computer combined with manual standard.According to the inclusion and exclusion criteria,the literature was screened,the NOS scale was used to evaluate the quality of the literature,the research data was extracted,and the R 3.5.1 software was used for Meta analysis.Results Finally,a total of 41 studies were included,with 1970 SLE patients(case group)and 1796 healthy people(control group).Meta analysis showed that the positive rate of serum AECA in the case group was 56.4%(95%CI:48.10-64.70),I²=95.00%],which was higher than that in the control groupOR=34.03(95%CI:21.79-53.14),P<0.01,I²=49.34%],the source of heterogeneity was enzyme-linked immunosorbent assay.Among them,the percentage of serum IgG type AECA positive cases in total AECA positive cases in the case group was 58.8%(95%CI:48.10-69.50),IgA type AECA accounting for 33.2%(95%CI:26.70-39.70),and IgM type AECA accounting for 12.7%(95%CI:2.60-22.70),the percentage of IgG type AECA positive cases was higher than those of IgA type and IgM type AECA(P<0.001).There was a positive correlation between serum AECA level and SLE disease activity index score in patients with SLEr=0.349(95%CI:0.23―0.46),P<0.001,I²=15.2%].There was no significant difference in the positive rate of AECA between patients with lupus nephritis and neuropsychiatric lupus(P=0.69).Conclusion AECA may be involved in the occurrence and development of SLE vascular damage,and serum AECA levels are related to SLE disease activity,and could be used for follow-up monitoring of SLE disease activity.In SLE,the IgG type AECA is mainly elevated,which should be paid attention to in clinical application.