564例抗磷脂抗体检测的临床意义

目的总结抗心磷脂抗体(ACA)、狼疮抗凝物(LA)、活化蛋白C抵抗性(APCR)检测与脑梗死、习惯性流产、系统性红斑狼疮(SLE)、深静脉血栓等血栓相关性疾病之间的关系及其临床意义。方法采用APIT-LA法筛选LA;酶联免疫吸附试验(ELISA)法检测ACA—IgG、IgM、IgA;活化蛋白C抑制比值法检测APCR。结果在检测的564例患者中,ACA—IgG、IgM、IgA的阳性率分别为30％、24％和11％,LA的阳性率为6．5％,APCR阳性率为7．9％。其中脑梗死64例,ACA—IgG、IgM、IgA的阳性率为14％,APCR的阳性率为7．8％,未发现LA阳性的病例。265例习惯性流产的患者中,ACA—IgG、IgM、IgA阳性率分别为19％、18％和3％,LA阳性率2．7％,APCR阳性率5．8％。171例的SLE患者中,ACA—IgG、IgM、IgA的阳性率分别为35％、25％和18％,LA阳性率8．8％,APCR阳性率为6％。其他原因不明的血栓性疾病患者64例,ACA—IgG、IgG、IgA的阳性率分别为78％、55％、22％,LA阳性率为30％,APCR的阳性率为23％。结论ACA、LA、APCR的检测对SLE、脑梗死、习惯性流产,尤其是原因不明的血栓性疾病患者的诊断和发病机制研究有重要价值。

Clinical Significance of 564 Antiphospholipid Antibodies Simples

Objective To investigate the clinical significace and correlation between anticardiolipin antibodies (ACA) ,lupus anticoagulant (LA) ,activated protein C resistance (APCR) and cerebral infarcton, recurrent abortion, Systemic lupus erythematosus (SLE) , deep vein thrombus. Methods ELISA, APTT-LA and APTT+/-APC methods were used to detect anticardiolipin antibodise(ACA) ,lupus anticoagulants(LA) and APCR. Results In 564 patients detected,positive rates of ACA-IgG, IgM, IgA, LA, APCR were 30% , 24%, 11%, 6.5% and 7. 9% , respectively. The positive results for 64 cerebral infarction patients were 14% , 14% , 14% , 0% , 7. 8% ;for 265 recurrent abortion patients were 19% , 18% , 3% , 2. 7% , 5. 8% ; for 171 SLE patients were 35% , 25% , 18% , 8. 8% , 6% ;for other 64 "unexplained" thrombosis patients were 78% , 55% , 22% , 30% and 23% , respectively. Conclusion Detection of ACA, LA and APCR are of significant in SLE, cerebral infarction, recurrent abortion, especially for diagnosis and pathogenesis in " unexplained" thrombosis patients.