不同亚型ACL和aβ2GPⅠ在SLE患者发病及病情发展中的临床意义

Clinical significance of different subtypes of anti-cardiolipin antibody and anti-β2-glycoproteinⅠantibody in onset and disease condition progress in patients with SLE

目的探讨不同亚型抗心磷脂抗体(ACL)与抗β2糖蛋白Ⅰ抗体(aβ2GPⅠ)在系统性红斑狼疮(SLE)患者发病及病情发展中的临床意义。方法将该院2017年2月至2019年2月收治的73例SLE患者纳为SLE组,30例非SLE结缔组织病患者纳为对照组A,30例健康体检者纳为对照组B,应用IgA/G/M多亚型筛选试剂与IgA、IgG、IgM单亚型试剂检测ACL与aβ2GPⅠ,分析不同亚型ACL与aβ2GPⅠ在SLE发病及病情发展中的临床意义。结果SLE组、对照组A、对照组B IgA/G/M型、IgG型ACL及IgA/G/M型aβ2GPⅠ阳性率差异有统计学意义(P<0.05),其中SLE组以上亚型抗体阳性率均明显高于其余两组(P<0.05)。SLE组、对照组A及对照组B之间血清IgA/G/M型、IgG型ACL,以及IgA/G/M型、IgA型、IgG型aβ2GPⅠ水平均呈依次下降趋势(P<0.05)。SLE组活动期患者血清IgG型ACL及IgA/G/M型、IgA型、IgG型aβ2GPⅠ水平均明显高于缓解期患者(P<0.05)。IgA/G/M型、IgG型ACL及IgA/G/M型、IgA型aβ2GPⅠ阴性组及阳性组间SLE患者血栓发生率差异有统计学意义(P<0.05)。结论IgA/G/M型、IgG型ACL及IgA/G/M型、IgA型、IgG型aβ2GPⅠ在诊断SLE及判断病情程度中的应用性强于其余亚型,IgA/G/M型、IgG型ACL及IgA/G/M型、IgA型aβ2GPⅠ与SLE患者血栓形成关系密切。

Objective To investigate the clinical significance of different subtypes of anti-cardiolipin antibody(ACL)and anti-β2-glycoproteinⅠantibody(aβ2GPⅠ)in the onset and disease condition progress in the patients with systemic lupus erythematosus(SLE).Methods Seventy-three cases of SLE treated in this hospital from February 2017 to February 2019 were included into the SLE group,30 patients with non-SLE connective tissue disease served as the control group A and 30 individuals undergoing the healthy physical examination were selected as the control group B.The ACL and aβ2GPⅠwere detected by IgA/G/M multiple subtypes screening reagents and IgA,IgG,IgM single subtype reagents.Then the clinical significance of different subtypes of ACL and aβ2GPⅠin the pathogenesis and development of SLE were analyzed.Results The positive rates of IgA/G/M and IgG types of ACL and IgA/G/M type of aβ2GPⅠhad significant difference among the SLE group,control group A and control group B(P<0.05),in which the above subtypes of antibody positive rates in the SLE group were significantly higher than those in the other two groups(P<0.05).The IgA/G/M and IgG types of ACL levels and IgA/G/M,IgA and IgG types of aβ2GPⅠlevels in the SLE group,control group A and control group B showed a decreasing trend in turn(P<0.05).The serum IgG type of ACL level and IgA/G/M,IgA and IgG types of aβ2GPⅠlevel in the active stage of the SLE group were significantly higher than those in the remission stage(P<0.05).There was statistically significant difference in the thrombosis incidence rate between the positive and negative groups of SLE patients with IgA/G/M and IgG types of ACL and IgA/G/M and IgA types of aβ2GPⅠ(P<0.05).Conclusion The applicability of IgA/G/M and IgG types of ACL and IgA/G/M,IgA and IgG types of aβ2GPⅠin diagnosing SLE is stronger than that of other subtypes,moreover,the IgA/G/M and IgG types of ACL and IgA/G/M and IgA types of aβ2GPⅠare closely related to the incidence rate of thrombosis in the patients with SLE.