测定抗心磷脂抗体、抗心肌线粒体抗体在诊治扩张型心肌病中的意义

目的比较抗心磷脂抗体(ACA)和抗心肌线粒体抗体(ACMA)对扩张型心肌病(DCM)诊断及治疗评估价值。方法采用ELISA法测定DCM,30例患儿ACA-lgG和ACMA-lgG,并与健康者对照,同时检测心肌酶、心电图和多普勒超声心动图。结果DCM患儿ACA-lgG和ACMA-lgG阳性率分别为53.3%和40.0%,均显著高于健康者(P<0.01)。ACA-G阳性患儿心肌酶CK-MB、心律失常发生率、心腔扩大率、左心收缩功能降低率均显著高于ACA-lgG阴性者(P<0.05);而ACMA-lgG阳性与否同上述改变无明显相关性(P>0.05)。结论ACA-lgG阳性对DCM患者诊断和病情轻重判定均有重要意义;ACMA-lgG阳性虽对DCM患儿诊断有一定价值,但对病情判断无作用。

Significance of comparison between anticardiolipin antibody and anticardiac mitochondrial antibody in dilated cardiomyopathy

Objective To compare the action of anticardionlipin antibody(AC-A) and anticardiac mitochondrial antibody (ACMA) in therapy and treatment of children with dilated cardiomyopathy(DCM). Mehtods ELISA was used to measure ACA-lgG and ACMA-lgG in 30 children with DCM and 40 healthy children as comtrols. CK-MB,electrocardiogram and Doppler echocardiography were examined simultaneously.Results The positive rate of ACA-lgG in DCM children was 53.3% and 40.4% respectively, both significantly higher than those of healthy children. The CH-MB level , the rate of arrhythmia,the enlargement rates of cardiacchambers and the decrease rate of systolic function of left ventricle(VL) were significantly higher in DCM children with ACA-lgG positive than those with ACA-lgG negative, but no significant difference betweeh ACMA-lgG positive and negative children.Conclusion The study showed that positive ACA played an important role in diagnosis of DCM, but helpless for judging the severity of DCM.