抗β2糖蛋白I抗体能否为血栓形成患者提供更多信息？

Does the anti-beta2-glycoprotein I antibody provide additional information in patients with thrombosis?

作者信息

Lee Eun Young, Lee Chang-Keun, Lee Tae Hoon, Chung Son Mi, Kim Seong Ho, Cho You Sook, Yoo Bin, Moon Hee-Bom

机构信息

Division of Allergy and Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-Dong, Songpa-Gu, Seoul 138-736, South Korea.

出版信息

Thromb Res. 2003;111(1-2):29-32. doi: 10.1016/j.thromres.2003.08.023.

DOI:10.1016/j.thromres.2003.08.023

PMID:14644075

Abstract

OBJECTIVE

To investigate whether the anti-beta(2)-glycoprotein I (anti-beta(2)GPI) antibody may provide additional information in patients with thrombosis in conjunction with the lupus anticoagulant (LAC) or anticardiolipin (aCL) antibody.

METHODS

We selected 235 patients whose plasma were tested for the presence of all three antiphospholipid (aPL) antibodies (LAC, aCL, and anti-beta(2)GPI) and were positive for at least one aPL antibody from January 2000 to December 2001. The LAC test was performed using dilute activated thromboplastin time reagent (dAPTT) and dilute Russell viper venom time reagent (dRVVT). ACL (IgG/IgM) and anti-beta(2)GPI (IgG/IgM) were detected by enzyme-linked immunosorbent assay (ELISA). Clinical data were collected and analysed in all patients with aPL antibody.

RESULTS

Of the 235 patients with aPL, thrombosis was detected in 76 patients (28.0%). Of the 76 patients with thrombosis, 29 were positive for LAC, 9 for aCL, 7 for anti-beta(2)GPI, 3 for LAC+aCL, 9 for aCL+anti-beta(2)GPI, 11 for LAC+anti-beta(2)GPI, and 8 for LAC+aCL+anti-beta(2)GPI. The rate of thrombosis was significantly different (p=0.01) among single positive patients (45/163, 27.6%), double positive patients (23/60, 38.3%), and triple positive patients (8/12, 66.7%). In single positive patients, the rate of thrombosis was highest in LAC positive patients (29/85, 34.1%). In double positive patients, the LAC+anti-beta(2)GPI positive group (11/24, 45.8%) and aCL+anti-beta(2)GPI positive group (9/22, 40.9%) had higher rates of thrombosis than the LAC+aCL positive group (3/14, 21.4%).

CONCLUSION

Single positivity for anti-beta(2)GPI explained 9.2% of thrombotic events in the absence of LAC or aCL. Double or triple positivity for aPLs were associated with a higher rate of thrombosis than single positivity for aPL. Our results suggest that anti-beta(2)GPI provides additional information in patients with thrombosis in conjunction with LAC or aCL.

摘要

目的

研究抗β2糖蛋白I（抗β2GPI）抗体是否能在狼疮抗凝物（LAC）或抗心磷脂（aCL）抗体的基础上，为血栓形成患者提供更多信息。

方法

我们选取了235例患者，这些患者的血浆在2000年1月至2001年12月期间接受了所有三种抗磷脂（aPL）抗体（LAC、aCL和抗β2GPI）的检测，且至少有一种aPL抗体呈阳性。LAC检测采用稀释活化部分凝血活酶时间试剂（dAPTT）和稀释蝰蛇毒时间试剂（dRVVT）。ACL（IgG/IgM）和抗β2GPI（IgG/IgM）通过酶联免疫吸附测定（ELISA）进行检测。收集并分析了所有aPL抗体阳性患者的临床资料。

结果

在235例aPL阳性患者中，76例（28.0%）检测到血栓形成。在76例血栓形成患者中，29例LAC阳性，9例aCL阳性，7例抗β2GPI阳性，3例LAC+aCL阳性，9例aCL+抗β2GPI阳性，11例LAC+抗β2GPI阳性，8例LAC+aCL+抗β2GPI阳性。单阳性患者（45/163，27.6%）、双阳性患者（23/60，38.3%）和三阳性患者（8/12，66.7%）的血栓形成率差异有统计学意义（p = 0.01）。在单阳性患者中，LAC阳性患者的血栓形成率最高（29/85，34.1%）。在双阳性患者中，LAC+抗β2GPI阳性组（11/24，45.8%）和aCL+抗β2GPI阳性组（9/22，40.9%）的血栓形成率高于LAC+aCL阳性组（3/14，21.4%）。