[原发性抗磷脂综合征的系统性红斑狼疮患者体内针对各种磷脂的抗体]
[Antibodies to various phospholipids in SLE patients with primary antiphospholipid syndrome].
作者信息
Reshetniak T M, Boĭtsekhovskaia B, Alekberova Z S, Kalashnikova L A, Mach E S, Zabek Ia
出版信息
Klin Med (Mosk). 1999;77(5):32-7.
Antiphospholipid antibodies (aPL) represent a heterogeneous population reacting with negatively charged, less frequently neutral phospholipids and/or phospholipid-binding serum proteins. The study was made of antibodies to a wide spectrum of phospholipids: to negatively charged phospholipids such as phosphatide acid (aPA), cardiolipin (aCL), phosphatidylcholine (aPS), phosphatidylinositol (aPI), phosphatidylglycerol (aPG) and to neutrally charged phospholipid--phosphatidylcholine (aPC)--in 54 patients with systemic lupus erythematosus (SLE) and 29 patients with primary antiphospholipid syndrome (PAPS). The test for lupus anticoagulant (LAC) was also made. aPL in SLE patients free of antiphospholipid syndrome were detected in 61, 36 and 9% (aPC, aPS and aPA, aCL, respectively). aPI and aPG did not exceed normal values. 81% of SLE patients with antiphospholipid syndrome were LAC positive and 88% aPL positive. 60, 53, 44, 40, 13 and 17 were positive to aPC, aPA, aPS, aCL, aPG and aPI, respectively. Among patients with PAPS, the highest positivity was by LAC, occurrence of the other aPL was the same as in SLE patients with antiphospholipid syndrome. aCL, aPA, aPC, aPS, aPG and aPI were found in 55, 52, 41, 38, 31 and 21% of cases, respectively. In clinical manifestations of antiphospholipid syndrome and negative tests for LAC and aCL it is advisable to make tests for aPS and aPC. aPC occur in SLE patients more frequently than the other aPL: in 63% of SLE patients free of antiphospholipid syndrome and in 60% of SLE patients with this syndrome. Antibodies to other phospholipids, but not to cardiolipin, were present in SLE + APS in half of the cases but in SLE + PAPS in one third of the patients. Occurrence of aCL in the serum of SLE + PAPS patients is associated with the presence of antibodies to any other phospholipid irrespective of the charge. The severity of vascular changes did not correlate with the number of aPL variant found in the serum.
抗磷脂抗体（aPL）是一类异质性抗体，可与带负电荷、较少情况下与中性磷脂和/或磷脂结合血清蛋白发生反应。本研究检测了54例系统性红斑狼疮（SLE）患者和29例原发性抗磷脂综合征（PAPS）患者针对多种磷脂的抗体：带负电荷的磷脂如磷脂酸（aPA）、心磷脂（aCL）、磷脂酰丝氨酸（aPS）、磷脂酰肌醇（aPI）、磷脂酰甘油（aPG），以及中性磷脂——磷脂酰胆碱（aPC）。同时也进行了狼疮抗凝物（LAC）检测。在无抗磷脂综合征的SLE患者中，aPC、aPS以及aPA、aCL的检出率分别为61%、36%和9%。aPI和aPG未超过正常值。81%患有抗磷脂综合征的SLE患者LAC阳性，88% aPL阳性。aPC、aPA、aPS、aCL、aPG和aPI的阳性率分别为60%、53%、44%、40%、13%和17%。在PAPS患者中，LAC阳性率最高，其他aPL的出现情况与患有抗磷脂综合征的SLE患者相同。aCL、aPA、aPC、aPS、aPG和aPI的检出率分别为55%、52%、41%、38%、31%和21%。在抗磷脂综合征的临床表现以及LAC和aCL检测为阴性的情况下，建议检测aPS和aPC。aPC在SLE患者中的出现频率高于其他aPL：在无抗磷脂综合征的SLE患者中为63%，在患有该综合征的SLE患者中为60%。在一半的SLE + APS病例以及三分之一的SLE + PAPS患者中存在针对其他磷脂而非心磷脂的抗体。SLE + PAPS患者血清中aCL的出现与针对任何其他磷脂（无论电荷情况）的抗体的存在相关。血管病变的严重程度与血清中发现的aPL变体数量无关。
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