冠心病和脑血栓病人血清抗心磷脂抗体水平变化

Anticardiolipin Antibodies in Patients with Coronary Heart Disease and Cerebral Thrombosis

目的 探讨冠心病和脑血栓病人血清抗心磷脂抗体 (ACLA)水平变化及其临床意义。方法 以ELISA方法检测 4 5例脑血栓患者及 10 0例冠心病 (CHD)患者的血清ACLA水平 ,同时以 2 2例健康体检者血清ACLA为对照。结果在年龄、性别等因素均衡的基础上 ,脑血栓及冠心病患者血清ACLA的平均结合指数 (BI)显著高于对照组 (P <0 0 1) ,且脑血栓患者与冠心病患者ACLA的阳性率均明显高于对照组 (P <0 0 5 )。脑血栓患者IgG ACLA的阳性率达 75 6 % ,IgM ACLA的阳性率达 6 8 9% ,具有一型以上阳性者为 6 4 4 % (指同一患者IgG ACLA ,IgM ACLA ,IgA ACLA三型中的任何两型或三型均为阳性 ) ,急性心肌梗死 (AMI)组的IgG ACLA、IgM ACLA阳性率则分别为 5 5 5 %和 4 4 4 % ,明显高于其他类型CHD(包括UAP ,SA ,OMI)患者 (P <0 0 5 ) ,而对照组仅一例阳性。结论ACLA与脑血栓、冠心病冠脉内血栓的形成关系密切 ,ACLA水平的升高可能是引发脑血栓和冠心病冠脉阻塞的原因之一。

Objective To investigate the changes of anticardiolipin antibodies(ACLA) in patients with coronary heart disease(CHD) and cerebral thrombosis and its clinical significance. Methods The levels of serum ACLA in 45 patients with first attack of cerebral thrombosis and 100 patients with CHD were examined by enzyme linked immunosorbent assay (ELISA). 22 healthy subjects served as control. Results The mean bound indexes of ACLA in patients with cerebral thrombosis and CHD were significantly greater than the age and sex matched healthy subjects( P< 0.01). The positive rates of ACLA were also significantly increased in patients compared with healthy subjects( P< 0.05). The positive rates of IgG-ACLA and IgM-ACLA were 75.6%, 68.9% respectively in patients with cerebral thrombosis. 68.9% of them was shown positively to mutiple ACLA(including IgG-ACLA, IgM-ACLA, IgA-ACLA). The positive rates of IgG-ACLA and IgM-ACLA were 55.5%, 44.4% respectively in patients with acute myocardial infarction(AMI) which were significantly elevated compared with other types of CHD(such as unstable angina pectoris, stable angina and occult mycardial infarction). However, there was only one positive (1/22) in healthy subjects. Conclusion Serum levels of ACLA were increased in patients with cerebral thrombosis and coronary artery thrombosis. The elevated levels of ACLA may be one of mechanisms triggering the attack of cardiocerebral thrombosis.