系统性红斑狼疮患者抗β2-糖蛋白Ⅰ抗体检测及其临床意义

Clinical significance of anti-β2 glycoprotein Ⅰ antibodies in systemic lupus erythematosus

目的探求抗β2-糖蛋白Ⅰ（β2 glycoprotein Ⅰ，β2-GPⅠ）抗体培G、IgA、IgM在系统性红斑狼疮（SLE）临床的测定。方法采用酶联免疫吸附试验（ELISA）检测100例SLE患者、39例疾病对照组（包括类风湿关节炎、硬化症、干燥综合征、自身免疫性肝病和混合性结缔组织病）和30例正常人群血清抗β2-GPⅠ抗体、抗心磷脂抗体（ACL）IgG、IgA、IgM等指标，分析其与临床特点（如血栓、流产）的关系。结果SLE组抗β2-GPⅠ抗体（IgG、IgA、IgM）浓度高于正常对照组，差异具有统计学意义（P〈0．01），敏感性、特异性、阳性预测值、阴性预测值分别为17．2％、95．7％、85．0％、44．6％。β2-GPⅠ抗体（IgG、IgA、IgM）与ACL抗体（IgG、IgA、IgM）两者呈正相关（r值分别为0．418、0．624、0．518、0．583，P〈0．01）。以SLE DAI为因变量对β2-GPⅠ抗体、ACL抗体、dsDNA、u1—RNP、Sm、SSA、SSB、Scl-70、Jo-1、P-蛋白、PT、APTT进行Logistic回归统计分析，入选的自变量有β2-GPⅠ—IgG和dsDNA。结论抗β2-GPⅠ抗体在SLE中具有一定敏感性和较高的特异性，与SLE的血栓形成相关，且抗β2-GPⅠ抗体IgG是SLE疾病活动性危险因素之一。检测抗β2-GPⅠ抗体在SLE中存在一定临床应用价值。

Objective To investigate the clinical application of anti-β2 glycoprotein Ⅰ antibodies （IgG, IgM, IgA）in systemic lupus erythematosus （SLE）. Methods The anti-β2-GP Ⅰ antibodies and anticardiolipin antibodies（ACL） level were measured by ELISA in 100 SLE patients, 39 other rheumatoid arthritis patients and 30 healthy control people. Their clinical application was analyzed in SLE diagnose and therapy. Results The level of anti-β2-GP Ⅰ （IgG, IgM, IgA）were significantly higher in SLE than that in healthy （P 〈 0.01 ）. Sensitivity, specificity, positive predictive value and negative predictive value were 17.2%, 95.7%, 85.0% and 44.6%, respectively. There was a significant and positive correlation between anti-β2-GP Ⅰ antibodies and ACL antibodies（IgG, IgM, IgA）（r =0.418, 0. 624, 0. 518, 0.583, P 〈 0.01）. In multivariate analysis the factors（ anti-β2-GP Ⅰ antibodies, ACL antibodies, dsDAN, ul-RNP, Sin, SSA, SSB, Jo-1, Scl-70, P-protein, PT, AFTT） associated with SLE disease activity index （SLEDAI） were anti-β2-GP Ⅰ （IgG） and dsDNA. Conclusion anti-β2-GP Ⅰ antibody has high specificity and positive predict value, also is associated with SLE＇s thrombosis. It has some values in the clinical application.