抗心磷脂抗体、蛋白C、蛋白S与缺血性脑血管病关系的研究

Relationship between Anticardiolipin Antibodies,Protein C or Protein S and Ischemic Cerebrovascular Disease

目的:探讨抗心磷脂抗体(aCL)、蛋白C(PC)、蛋白S(PS)与缺血性脑血管病(ICVD)的关系。方法:检测266例ICVD患者血清aCL,94例的血浆蛋白C:抗原(PC:Ag)、总蛋白S(TPS)和游离蛋白S(FPS),同时测定19例ICVD患者蛋白C:活性(PC:AC)。结果:ICVD患者aCL阳性率高于对照组(P<0.01),且IgG型aCL比IgM型aCL阳性率升高(P<0.01)。aCL≥10 GPL或MPL的ICVD患者发病年龄轻且易复发。ICVD组PC:Ag、TPS、FPS、PC:AC异常降低者多于对照组(P<0.05或P<0.01)。综合分析ICVD患者aCL与PC和PS的关系发现,aCL水平与PC、TPS、FPS水平呈负相关。结论:aCL(特别是IgG型aCL)与ICVD关系密切,aCL对PC、PS抗凝功能的影响可能是其导致血栓形成和发展的主要原因之一。

Objective:To study the relationship between anticardiolipin antibodies (aCL)、protein C (PC) or protein S (PS) and ischemie cerebrovascular disease (ICVD). Methods:The aCL level was measured in 266 patients with ICVD. Protein C: An-tigen (PC:Ag) ,total protein S (TPS) and free protein S(FPS) were measured in 94 patients,and protein C:activity (PC: AC) was also measured in 19 patients. Results: The results that showed an increased level of aCL were found in patients with ICVD. The difference of aCL between patients and controls was very significant (P<0.01). The level of elevated IgG-aCL was significantly higher than that of IgM-aCL in patients with ICVD (P<0.01). The high level of aCL (≥10 GPL/MPL) was commonly found in young patients with recurrent ICVD. The levels of PC:Ag,FPS and PC:AC in patients were lower than those in controls (P<0.01 or P<0.05).A correlation analysis was made to study the relationship be-tween aCL and PC、PS in patients with ICVD. The results revealed that the higher the level of aCL elevated, the lower the levels of PC:Ag,TPS and FPS decreased. Conclusion:aCL,especially IgG-aCL,is closely associated with ICVD. The effect of aCL on anticoagulant function of PC and PS may be one of the main causes to contribute thrombosis.