慢性阻塞性肺疾病抗心磷脂抗体水平分析

Analysis on serum anticardiolipin antibody level in chronic obstructive pulmonary diseases

目的探讨抗心磷脂抗体(ACA)与慢性阻塞性肺疾病(COPD)的关系。方法采用ELISA法检测了103例COPD患者与72例健康对照者血清中的ACA IgG/A/M,将COPD组103例分成ACA阳性和阴性两组,分析ACA与患者性别、年龄、体质量指数(BMI)和肺功能指标之间的关系。结果从定性角度,在COPD组和健康对照组中,ACA的阳性率分别为16.5%(17/103)和4.2%(3/72),两者之间差异有统计学意义(P<0.05);在COPD的"慢性阻塞性肺疾病全球倡议"(GOLD)分期中,从GOLDⅠ到GOLDⅣ,ACA的阳性率依次为66.7%、18.5%、13.9%、3.2%,逐渐降低。从定量角度,COPD组ACA浓度为(4.4±0.7)RU/mL,高于健康对照组的(2.6±0.4)RU/mL,差异有统计学意义(P<0.05);其中,从GOLDⅠ到GOLDⅣ,ACA浓度依次为(10.9±2.6)、(3.9±1.0)、(4.8±1.4)、(2.5±0.6)RU/mL。ACA阳性的COPD患者主要集中在GOLDⅠ,GOLDⅠ的ACA阳性率和浓度远高于其他各期。其中,ACA阳性与阴性COPD患者的性别、年龄和BMI等比较,差异无统计学意义(P>0.05)。结论 ACA与COPD的GOLD分期有关联,主要出现在疾病早期。ACA可能是诊断早期COPD的新型标志物,并在COPD的发病机制中起到一定作用。

Objective To investigate the relation between anticardiolipin antibody（ACA）with chronic obstructive pulmonary diseases（COPD）.Methods The ELISA method was adopted to detect the serum ACA IgG/A/M levels in 103 cases of COPD and 72 healthy controls.The COPD group was subdivided into the ACA positive subgroup and ACA negative subgroup.The relation between the gender,age and body mass index（BMI）with the lung function indexes was compared between the ACA positive and negative patients.Results In the qualitative angle,ACA positive rates in the COPD group and the healthy control group were 16.5%（17/103）and 4.2%（3/72）respectively,showing the statistical difference between them（P〈0.05）,in the staging by the Global Initiative for Chronic Obstructive Pulmonary Disease（GOLD）,the ACA positive rates in the stage Ⅰ- Ⅳ were in turn 66.7%,18.5%,13.9% and 3.2%,which were gradually declined.In the quantitation angle,the ACA concentration in the ACA group was（4.4±0.7）RU/mL,which was much higher than（2.6±0.4）RU/mL in the healthy control group（P〈0.05）;which in the GOLD stageⅠ- Ⅳ were（10.9±2.6）,（3.9±1.0）,（4.8±1.4）,（2.5±0.6）RU/mL respectively.The COPD patients with ACA positive were mainly concentrated at the GOLD stageⅠ,the ACA positive rate and concentration at the GOLD stageⅠ were much higher than those in the other GOLD stages.The ACA positive had no obvious association with the gender,age and BMI in the COPD patients（P〉0.05）.Conclusion ACA has an association with the GOLD stage in COPD and mainly appears at the early stage of the disease.ACA may be used as a novel marker in the early diagnosis of COPD and may play certain role in the pathogenesis of COPD.