淋巴细胞贴壁试验诊断风湿性心脏病意义的探讨

Leucocyte adherence inhibition assay in the diagnosis of rheumatic carditis

目的 为寻找新的特异性和敏感性的指标 ,以探讨风湿热的活动性 ,从而提高风湿热和风心病的诊疗水平。方法 用A组乙型溶血链球菌特异性菌膜抗原和 1%植物血凝素 (PHA)作为刺激物 ,分别测定 38例健康对照组 ,30例风湿性心脏病风湿活动组 ,2 4例风湿性心脏病静止组的外周血淋巴细胞贴壁抑制百分率 (Lymphocyteadherencein hibitionpercent,LAIP)和促凝血活性 (Procoagulantactivity ,PCA)。结果 风心病活动组IAIP(34 47%± 4 5 6 % )显著高于风心静止组 (13 5 6 %± 3 31% )和健康对照组 (12 5 0 %±3 73% ) ,而后二者无统计学显著差异。风心活动组、风心静止组、健康对照组的淋巴细胞贴壁抑制指数同PCA相关系数分别为 0 85 94、0 8431、0 82 87,存在着正相关性 ,在统计学上无差异。PCA阳性率略高于LAIP ,但是二者无统计学差异。结论 LAIP在判断风湿活动方面有较大价值。

Objective To improve the diagnosis and treatment of rheumatic fever and probe for specific and sensitive methods for detecting the activity of rheumatic fever. Method A specific antigen from group A streptococcal cell membrane and 1% PHA used as a stimulant to test the peripheral blood lymphocyte adherence inhibition percent (LAIP) and procoagulant activity (PCA) in 30 cases of active rheumatic carditis, 24 cases of inactive rheumatic carditis and 38 cases of normal controls. Results LALP of active rheumatic carditis groups are much higher than those of normal controls and inactive rheumatic carditis groups ( P <0.05). There was no statistical difference between inactive rheumatic carditis groups and normal controls groups. It was found that a positive relationship between LAIP and PCA and no statistical difference of positive rate. Conclusion LAIP is of important significance in the diagnosis of rheumatic carditis.