抗磷脂抗体和抗凝蛋白系统与系统性红斑狼疮血栓前状态的关系

The relationship of prethrombotic state with antiphospholipid antibody and anticoagulant protein system in systemic lupus erythematosus patients

目的探讨抗磷脂抗体和抗凝蛋白系统与系统性红斑狼疮(SLE)血栓前状态的关系。方法蛋白C(PC)测定采用酶联免疫法(ELISA)、凝固法测定蛋白S(PS)活性、抗心磷脂抗体(ACA)检测采用金标法,狼疮抗凝物(LA)检测采用激活的部分凝血活酶时间(PTT)测定法。结果SLE患者蛋白S、蛋白C活性显著下降,狼疮抗凝物(LA)增加,抗心磷脂抗体(ACA)阳性率增加,表现为抗凝蛋白系统功能减弱;同时LA和ACA与PS、PC有显著的负相关性。结论LA和ACA可能是导致PS、PC活性下降的重要因素之一,而PS、PC活性下降可能进一步诱发血栓。因此,抗磷脂抗体和抗凝蛋白系统的联合检测对SLE并发血栓可能有预测价值。

Objective To investigate the relationship of prethrombotic state with antiphospholipid antibody and anticoagulant protein system in systemic lupus erythematosus （ SLE ） patients. Methods Protein C （ PC ） are detected by enzymelinked immunosorbent assay （ELISA） ; the activity of protein S （PS） is detected by coagulation method; anticardolipin antibodies （ACA） are detected by golden standard method; lupus anticoagulant （LA） is deteted by activated partial thromboplastin time method. Results The activity of PS and PC in systemic lupus erythematosus patients significantly decrease; lupus anticoagulant level is enhanced and anticardolipin antibodies are dectected positively; furthermore, LA and ACA are remarkably negatively associated with the level of PS and PC. Conclusion The results indicated that LA and ACA are probably the key clement to cause the activity decrease of PS and PS, which maybe induce thrombus in systemic lupus erythematosus patients. Therefore, combined determination of antiphospholipid antibody and anticoagulant protein system should be a valuable forecast for SLE; patients with thrombus complication.