Ishikura Ken, Wada Hideo, Kamikura Yuko, Hattori Kyouko, Fukuzawa Toshiaki, Yamada Norikazu, Nakamura Masio, Nobori Tsutomu, Nakano Takeshi
First Department of Internal Medicine, Mie University School of Medicine, Tsu, Mie, Japan.
Am J Hematol. 2004 Aug;76(4):338-42. doi: 10.1002/ajh.20124.
The present study was designed to determine the prevalence of lupus anticoagulant (LA) antibody and several antibodies for antiphospholipid syndrome (APS) in patients with deep vein thrombosis (DVT)/pulmonary embolism (PE) (n = 48), cerebral thrombosis (CT, n = 30), systemic lupus erythematosus (SLE, n = 22), and idiopathic thrombocytopenic purpura (ITP, n = 30). The presence of antibodies was examined by using the respective ELISA kits. LA was positive in 38.6% of patients with DVT/PE, suggesting that LA is one of the most important risk factors in DVT/PE. The highest prevalence of anti-beta(2) glycoprotein I (beta(2)GPI) IgG was in CT and SLE, followed by DVT, and none in ITP and healthy volunteers (control, n = 40), suggesting that it is related to thrombosis, particularly arterial thrombosis. The highest prevalence of anti-prothrombin (aPT) IgG antibody was in DVT, followed by CT and SLE, and none in ITP and the control, suggesting that it is related to thrombosis, especially venous thrombosis. The highest prevalence of antiphospholipid (aPL) IgG was in DVT, CT, and SLE, but 0% in ITP and control. On the other hand, aPL IgM, anti-annexin V IgG, and anti-annexin V IgM were positive in patients both with and without thrombosis, suggesting that they are not related to thrombosis. Our results indicated that among the anti-phospholipid antibodies, LA is the most sensitive marker for APS while anti-beta(2)GPI IgG, aPT IgG, and aPL IgG are risk factors for thrombosis. In particular, aPT IgG is a significant marker for DVT/PE.
本研究旨在确定深静脉血栓形成(DVT)/肺栓塞(PE)患者(n = 48)、脑血栓形成(CT,n = 30)、系统性红斑狼疮(SLE,n = 22)和特发性血小板减少性紫癜(ITP,n = 30)中狼疮抗凝物(LA)抗体及几种抗磷脂综合征(APS)抗体的患病率。使用相应的酶联免疫吸附测定(ELISA)试剂盒检测抗体的存在情况。38.6%的DVT/PE患者LA呈阳性,这表明LA是DVT/PE最重要的危险因素之一。抗β2糖蛋白I(β2GPI)IgG在CT和SLE患者中的患病率最高,其次是DVT患者,而ITP患者和健康志愿者(对照组,n = 40)中无一例阳性,这表明其与血栓形成有关,尤其是动脉血栓形成。抗凝血酶原(aPT)IgG抗体在DVT患者中的患病率最高,其次是CT和SLE患者,而ITP患者和对照组中无一例阳性,这表明其与血栓形成有关,尤其是静脉血栓形成。抗磷脂(aPL)IgG在DVT、CT和SLE患者中的患病率最高,但在ITP患者和对照组中为0%。另一方面,aPL IgM、抗膜联蛋白V IgG和抗膜联蛋白V IgM在有血栓形成和无血栓形成的患者中均呈阳性,这表明它们与血栓形成无关。我们的结果表明,在抗磷脂抗体中,LA是APS最敏感的标志物,而抗β2GPI IgG、aPT IgG和aPL IgG是血栓形成的危险因素。特别是,aPT IgG是DVT/PE的重要标志物。