抗磷脂抗体在心脑血管缺血性疾病的临床意义

Research of anti-phospholipid antibody in ischemic cardiovascular and cerebral vascular diseases

目的 研究抗磷脂抗体 (APA)在心脑血管缺血性疾病的临床意义。方法 应用酶联免疫吸附法 (ELISA)检测60例缺血性脑血管病短暂性脑缺血发作 (TIA)与脑梗死各 30例 ,60例缺血性心脏病 (心绞痛与心肌梗死各 30例 )患者血清中抗心磷脂抗体 (ACA) ,包括ACA -IgG及ACA -IgM ,并与 30例正常对照组比较。结果 ①本组 1 2 0例心脑缺血性疾病患者中ACA阳性率 34 1 7% ,明显高于健康对照组的 6 7% (P <0 0 5)。②ACA阳性患者脑卒中复发率与多灶率明显高于ACA阴性患者 (P <0 0 5)。③ACA阳性与是否有心律失常无关 (P >0 0 5)。④ACA阳性患者血液黏稠度明显高于ACA阴性患者 ,并有微循环指标异常。⑤ACA -IgG于发病 1周内增高明显。结论 APA在心脑缺血性疾病发病中起重要作用 ,其能够诱发血液高凝状态 ,引起血栓形成。

Objective To study the clinical significance of anti-phospholipid antibody(APA)in ischemic cardiovascular and cerebral vascular diseases.Methods Serum anti-cardiolipin antibody(ACA)including ACA-IgG and ACA-IgM was measured in 60 patients with ischemic cardiovascular and cerebral vascular diseases(including 30 cases with TIA and 30 cases with cerebral infarction),and in 60 patients with ischemic cardiovascular diseases(including 30 cases with angina pectoris and 30 cases with myocardial infarction),and compared with control group (30 cases).Results ①The positive rate of ACA in 120 patients with ischemic cardiovascular and cerebral vascular diseases was 34 17%,that was much higher than 6 7% in the control(P<0 05).②Compared with the ACA negative patients (P<0 05),cerebral vascular diseases in ACA positive group tended to be recurrent and multiple event.③The ACA positive was not associated with arrhythmia(P>0 05);④The rate of the blood viscosity in ACA positive group was much higher than the negative group and the data of micro circulation in blood viscosity was unusual.⑤The data of the ACA-IgG rose rapidly in the first week.Conclusion Anti-phospholipid antibody was one of the important factors that caused the ischemic cardiovascular and cerebral vascular diseases,and it tended to induce blood coagulation and also caused thrombosis easily.