SLE患者抗磷脂抗体纵行观察的初步分析

THE PRIMARY ANALYSIS OF VERTICAL OBSERVATION OF PATIENTS WITH ANTICARDDIOLIPIN ANTIBODIES IN SLE

本文对７４例ＳＬＥ患者ＩｇＧ－ＡＣＬ纵行观察四年，就其变化和临床相关性进行分析。３９例ＡＣＬ阳性组中３４例（８７％）的中等至严重活动性ＳＬＥ，而ＡＣＬ阴性组仅１３／３５（３７％）。ＡＣＬ阳性与ＳＬＥ疾病的活动性密切相关。ＡＣＬ阳性组在血栓形成、自发性流产、中枢神经系统损害、血小板下降方面均较ＡＣＬ阴性组有显著的差别。阳性ＡＣＬ组又可分为：持续ＡＣＬ阳性的Ａ组和ＡＣＬ有波动的Ｂ组。Ａ组患者较Ｂ组更容易发生血栓、抗磷脂抗体综合征，特别是脑血栓等中枢神经系统病变，这是ＡＣＬ持续阳性ＬＬＥ患者的临床特征之一。

eventy four patients with Systemic Lupus Erythematosus(SLE)were verticalypreserved for four years.The association between the variation of IgG-anticardiolipisantibody(IgG-ACL)and clinic manifestations was analyzed in thirty nine patientswith positive I IgG-ACL and thirty five patients with negative IgG-ACL.According todisease activity score,the patients were divided into four groups,such as severe,modesrate,mild active and inactive, respectively.there were 87%patients with severe andmoderate activety in the positive IgG-ACL group,and only 37%in the negative group.There were significant association between positive ACL and disease activety of SLE.The incidences of thromboembolic events,spontaneous abortion,central nervous system(CNS) lesion and thrombocytopenisa in positive IgG-ACL group were significantlyhigher than those in negative group(P 0.05).The patients with positive IgG-ACLwere classified into two groups :group A ,perisitently positive for IgG-ACL;group B,positive only during active phases.By contrast,the incidences of thrombosis,thrombo-cytopenia and antiphospoolipic syndrome in group A were significantly higher thanthose in group B(P 0.05),particularly the cerebrovascular accident. CNS lesion isthe one of the clinic characteristics in patients with persistently positive IgG-ACL.This study suggests that ACL is not only the one of the diagnosis criteria for APS,but also the one of the parameters of high risk predictor and following up treatmentfor thrombosis,cerebrovascular accident and spontaneous abortion in patients withSLE.