抗心磷脂抗体在神经精神性狼疮中的临床研究

目的探讨抗心磷脂抗体在神经精神性狼疮中的意义。方法采用ELISA方法，检测93份血清（包括NPLE患者33例，无神经精神症状的狼疮患者35例，非SLE所致脑血管意外患者25例）和17例脑脊液（包括NPLE患者6例，无神经精神症状的狼疮患者5例，非SLE所致脑血管意外患者6例）中的抗心磷脂抗体。结果血清中抗心磷脂抗体（ACA）IgG、IgM阳性率分别为59．1％、57％，其中33例神经精神性狼疮患者阳性率为90．9％，87．9％，35例无神经精神症状的狼疮患者阳性率为34．3％，25例非系统性红斑狼疮脑血管意外患者阳性率为52％，48％各组之间有显著差异（P〈0．005）。NPLE患者组与无神经精神症状的狼疮患者组及非系统性红斑狼疮脑血管意外患者组之间均有显著差异（P〈0．05）。脑脊液中ACA—IgG、ACA—IgM阳性率分别为6／17、5／17，NPLE患者组与无神经精神症状的狼疮患者组及非系统性红斑狼疮脑血管意外患者组之间均无显著差异（P〉0．05）。33例NPLE患者，血清ACA—IgG、IgM检测、认为、弥漫性表现患者与局灶性表现患者比较，血清ACA、抗体水平不同，局灶性表现患者升高较明显（P〈0．05）。结论血清中ACA与NPLE密切相关。

Clinical value of anti-cardiolipin antibodies in neuropsychiatric lupus erythematosus

Objective To study the clinical value of anti-cardiolipin antibodies(ACA) and anti-ganglioside antibodies (AGA) in people with neuropsychiatric lupus erythematosus (NPLE). Methods 93 serum ( 33 with NPLE, 35 no neuropsychiatric manifestations of SLE and 25 no-SLE cerebrovascular disease ) and 17 cerebrospinal fluids (6 with NPLE, 5 no neuropsychiatric manifestations of SLE and 6 no-SLE cerebrovascular disease ) were examined for anti-cardiolipin antibodies by ELISA method. Results The positive rates of ACA were 90.9%(IgG) and 87.9%(IgM) in NPLE, 34.3%(IgG and IgM) in no neuropsychiatric manifestations of SLE, 52%(IgG) and 48%(IgM) in no-SLE cerebrovascular disease. There was significant difference between NPLE and others in serum (P<0.05). The positive rates of ACA were 3/6(IgG) and 2/6(IgM) in NPLE ,1/5(IgG) and 1/5(IgM) in no neuropsychiatric manifestations of SLE, 2/6(IgG) and 2/6(IgM) in no-SLE cerebrovascular disease. There was not significant difference among three groups in CSF (P>0.05). Sera anti-cardiolipin antibodies levels were significantly elevated in NPLE , with acute confusion state or psychiatric disorder had relatively higher levels of anti-cardiolipin antibodies than other NPLE (P<0.05). Conclusions Serum anti-cardiolipin antibodies may be helpful to clinical diagnosis of NPLE.