抗心磷脂抗体、抗心肌线粒体抗体测定在扩张型心肌病的意义

Comparison between anticardiolipin antibody and anticardiac mitochondrial antibody in dilated cardiomyopathy

目的 比较抗心磷脂抗体 (ACA)和抗心肌线粒体抗体(ACMA)对小儿扩张型心肌病 (DCM)诊断及病情了解的作用。方法 采用ELISA法测定DCM 30例ACA IgG和ACMA IgG ,并与健康儿童对照 ,同时检测心肌酶、心电图和多普勒超声心动图。结果 DCM患儿ACA IgG和ACMA IgG阳性率分别为5 3.3%和 40 .0 % ,均显著高于健康儿 (P均 <0 .0 0 1)。ACA IgG阳性儿心肌酶CK MB、心律失常发生率、心腔扩大率、左心收缩功能降低率均显著高于ACA IgG阴性者 (P均 <0 .0 5 ) ;而ACMA IgG阳性与否同上述改变无明显相关性 (P均 >0 .0 5 )。结论 ACA IgG阳性对DCM儿诊断和病情轻重均有重要意义 ;ACMA IgG阳性虽对DCM患儿诊断有一定价值 ,但对病情判断无作用。

Objective To compare the action of anticardiolipin antibody(ACA)and anticardiac mitochondrial antibody (ACMA) in children with dilated cardiomyopathy(DCM). Methods ELISA was used to measure ACA-IgG and ACMA-IgG in 30 children with DCM and 40 healthy children as controls.CK MB,electrocardiogram and Doppler echocardiography were examined simultaneously. Results The positive rate of ACA-IgG in DCM children was 53.3% and 40.0% respectively,both significantly higher than those of healthy children.The CK MB level,the rate of arrhythmia,the enlargement rates of cardiac chambers and the decrease rate of systolic function of left ventricle (LV) were significantly higher in DCM children with ACA-IgG positive than those with ACA-IgG negative,but no significant difference between ACMA-IgG positive and negative children. Conclusion The study showed that positive ACA played an important role in diagnosis and awareness of its severity of DCM. Positive ACMA had a certain value in diagnosis of DCM, but helpless for judging the severity of DCM.