冠心病患者血清中相关自身抗体的检测及临床意义

Detection and clinical significance of serum autoantibodies associated with coronary arteriosclerosis

目的:探讨血清中抗氧化型低密度脂蛋白(ox-LDL)抗体和抗内皮细胞抗体(AECA)这2种自身抗体与冠状动脉粥样硬化的关系。方法:分别用酶联免疫吸附法(ELISA)和间接免疫荧光法(IIF)检测118例冠状动脉硬化性心脏病患者及44名健康对照者血清ox-LDL和AECA水平,同时用生化方法检测其血脂水平。结果:冠心病组血清抗ox-LDL抗体阳性率为32.20%,明显高于正常对照组阳性率6.82%(P=0.001);血清抗内皮细胞抗体阳性率冠心病组为38.14%,健康对照组为13.64%(P=0.002)。在血脂正常的冠心病组中抗ox-LDL抗体阳性率25.00%也高于正常对照组(P=0.045)。结论:血清中上述2种自身抗体阳性率与冠状动脉粥样硬化密切相关,而且抗ox-LDL抗体阳性率与血脂无明显相关性,自身免疫反应是动脉粥样硬化的一种可能的发病机制。

Objective To explore the relationship between the serum anti-oxidized low density lipoprotein (anti-ox-LDL) and anti-endothelial cell autoantibodies (AECA) and the coronary arteriosclerosis. Methods The serum levels of the anti-ox-LDL antibody and the AECA were measured respectively by ELISA and indirect immunofluorescence (IIF) in 118 patients with coronary arteriosclerosis disease(CAD) and 44 healthy controls. The plasma lipid levels were simultaneously detected by the biochemical method. Results The positive rates of the serum anti-ox-LDL antibody and the serum AECA in CAD patients were significantly higher than those in controls (32.20% versus 6.82%, P=0.001 and 38.14% versus 13.64%, P=0.002, respectively). In addition, the positive rate of the serum anti-ox-LDL antibody was also higher in CAD patients with normal plasma lipid levels than that in controls (P=0.045). Conclusions The positive rates of the serum anti-ox-LDL antibody and the serum AECA are closely related to the coronary arteriosclerosis. There is no obvious correlation between the positive rate of the serum anti-ox-LDL and the plasma lipid levels. The autoimmune reaction might play an important role in the pathogenesis of the atherosclerosis.