脑梗死患者抗磷脂抗体的测定与临床意义

Detection and its clinical significance of antiphospholipid antibodies in patients of cerebral infarction

目的探讨抗磷脂抗体(APA)与脑梗死之间的关系及其临床意义。方法对157例脑梗死(C I)患者和82例正常对照组(NC)采用酶联免疫吸附试验(ELISA)检测ACA-IgG、IgM、IgA,血浆部分凝血活酶时间-狼疮抗凝物法(PTT-LA)筛选狼疮抗凝物(LA)。结果C I组血清中ACAIgG、IgM、IgA以及LA的阳性率均明显高于NC组(P<0.05);C I组总APA阳性率(25.5%)显著高于NC组(4.9%),P<0.01;多灶性C I组APA的阳性率(36.5%)明显高于单灶性C I组(15.7%),P<0.05;在40例APA阳性脑梗死的病因分析中,≤50岁C I组单纯APA阳性率(58.3%)显著高于>50岁C I组单纯APA阳性率(14.3%),P<0.05;女性C I组与男性C I组之间APA阳性率差异无统计学意义。结论抗磷脂抗体与脑梗死密切相关,且以多灶性脑梗死多见,尤其是原因不明的脑梗死患者重要的致病危险因素。

Objective To investigate the clinical significance and correlation between antiphospholipid antibodies（APA） and cerebral infarction（CI）. Methods ELISA and PTT-LA methods were used to detect ACA-IgG, IgM ,IgA and anticoagulants （ LA ） in 157 patients with cerebral infarction and 82 normal controls（NC）. Results In 157 patients detected,positive rates of ACA-IgG,IgM,IgA, LA were significantly higher than those in NC group （ P 〈0.05 ）. The total incidence of APA in CI （25.5%） was significantly higher than that in NC group（4.9% ） ,P 〈 0. 01. The incidence of APA in multiple CI （36.5%） was significantly higher than that in single CI group（ 15.7% ）, P 〈 0. 05. In the causal analysis of 40 APA-positive patients, The incidence of pure APA-positive in ≤ 50 years CI group（58.3% ） was significantly higher than that in 〉50 years CI group（ 14.3% ） ,P 〈0.05. But there was no significant difference of APA between female and male CI groups. Conclusion APA is closely associated with CI, and its positive rate is significantly higher in multiple CI than that in single CI group, which is an important risk factor in young patients of unknown cause.