抗β_2-糖蛋白Ⅰ抗体在系统性红斑狼疮中的临床意义

Anti-β_2-glycoprotein Ⅰ antibodies in patients with systemic lupus erythematosus

目的了解抗!2-糖蛋白Ⅰ抗体(抗!2-GPⅠ抗体)与系统性红斑狼疮(SLE)临床特点的关系及在其诊断中的价值。方法采用酶联免疫吸附试验(ELISA)检测112例SLE患者、40例类风湿关节炎(RA)患者、30例干燥综合征(SS)患者和40名正常人血清中的抗!2-GPⅠ抗体水平。同时,测定患者血清中的抗心磷脂抗体(ACL)等指标,并分析其与患者的临床特点(如:血栓、流产)的关系及其临床意义。统计学分析采用t检验、!2检验和Spearman检验。结果抗!2-GPⅠ抗体在SLE中敏感性为21.4%(24/112),特异性为88.6%,在RA和SS敏感性分别为15.0%(6/40)和6.7%(2/30),40名正常对照均为阴性。抗!2-GPⅠ抗体与血栓形成密切相关(P<0.01),与ACL-IgG和IgM型水平呈正相关(r=0.479,P=-0.032;r=0.400,P=0.045)。抗!2-GPⅠ抗体与其他临床及实验室指标无明显相关性。结论抗!2-GPⅠ抗体在SLE中具有一定的敏感性,且可能在SLE的血栓形成中发挥作用,联合检测ACL与抗!2-GPⅠ抗体能够辅助诊断SLE伴血栓形成。

Objective To investigate the prevalence and significance of anti-132-glycoprotein Ⅰ （anti-β2-GP Ⅰ ） in patients with systemic lupus erythematosus （SLE）. Methods Anti-β2-GP Ⅰ level was determined in 112 SLE patients, 40 patients with rheumatoid arthritis （RA）, 30 patients with Sjtigren＇s syndrome （SS） and 40 healthy individuals by enzyme-linked immunosorbont assay （ELⅠSA）. The laboratory and clinical features （thrombosis, fetal loss, etc） were analyzed retrospectively from the clinical database. Restflts Sensitivities of anti-β2-GP Ⅰ were 21.4%, 15.0%, 6.7% in SLE, RA and SS, respectively. The specificity of anti- β2-GP ] was 88.6% in SLE. Correlations between thrombosis and titers of ACL-ⅠgG/ⅠgM and anti-β2-GP Ⅰ were statistically significant. No association was found between anti-β2-GP Ⅰ and other clinical and laboratory features. Conclusion The results indicate that anti-β2-glycoprotein Ⅰ antibodies are common and may play a role in SLE with thrombosis. Combination of ACL and anti-β2-GP Ⅰ can facilitate the diagnosis of SLE with thrombosis.