系统性红斑狼疮抗活化的蛋白C研究

Activated protein C resistance in systemic lupus erythematosus

目的 了解抗活化的蛋白C(APCR)在系统性红斑狼疮 (SLE)患者中的发生情况 ,并进一步探讨SLE患者发生血栓的机制。方法 采用APC KPTT法 ,ELISA法和PTT LA法分别对5 0例SLE患者及 2 0例正常对照 (NC)进行APCR、抗心磷脂抗体 (ACA)和狼疮抗凝物 (LA)检测。结果 SLE患者APCR阳性率 ( 5 8% )明显高于NC组 ( 5 % ) (P <0 0 0 5 ) ,APCR阳性患者中血栓发生率( 2 7 6% )明显高于APCR阴性患者 ( 4 8% ) (P <0 0 1) ,患者LA阳性率 ( 2 2 % )明显高于对照组 ( 0 /10 ) (P <0 0 5 ) ,患者ACA IgG及IgM明显高于对照组 (P <0 0 5 ) ,而IgA与对照组差异不显著 (P >0 0 5 ) ,LA阳性组中的APCR阳性率 ( 90 9% )明显高于LA阴性组 ( 5 3 8% ) (P <0 0 5 ) ,ACA阳性组中的APCR阳性率 ( 64 7% )与ACA阴性组 ( 60 6% )未发现明显相关性 (P >0 0 5 )。结论 APCR在国人SLE患者中有较高的发生率且与LA有明显相关性 ,APCR可能是SLE患者诱发血栓的主要原因之一。

Objective To know the occurrence of activated protein C resistance (APCR) in Chinese patients with systemic lupus erythematosus (SLE) and investigate the occurring mechanism of thrombosis in SLE.Methods APC KPTT assay,ELISA and PTT LA methods were used respectively to detect APCR,anticardiolipin antibodies (ACA) and lupus anticoagulants (LA) in 50 patients with SLE and 20 normal controls (NC).Results The incidence of APCR in SLE (58%) was significantly higher than that in NC group (5 0%) ( P <0 005),the incidence of thrombosis in APCR positive (27 6%) was significantly higher than in APCR negative (4 8%) ( P <0 05),the incidence of LA in SLE (22%)was significantly higher than in NC group (0/20) ( P <0 05) and the ACA IgG and IgM in SLE was higher than in NC group ( P <0 05),but there was no significant difference of ACA IgA between two groups ( P >0 05),the incidence of APCR in LA positive (90 9%) was obviously higher than in LA negative (53 8%) samples of patients with SLE ( P <0 05),but the ACA was not significantly associated with APCR ( P >0 05).Conclusion There is a few higher incidence with APCR in Chinese patients with SLE and related to LA.APCR seems to be one of the main reasons to induce the thrombosis in patients with SLE.