Kitagawa Y, Okayasu H, Matsuoka Y, Mihara B, Koto A
Department of Internal Medicine, Kawasaki Municipal Hospital.
Rinsho Shinkeigaku. 1991 Apr;31(4):391-5.
We investigated the anticardiolipin antibody (ACA) in a series of patients with cerebral infarction without systemic lupus erythematosus (SLA). Clinical and laboratory data were assessed from a series of 250 non-SLE patients with cerebral infarction who visited our clinic from 1988 to 1990. The concentration of anticardiolipin IgG antibody was measured by an enzyme-linked immunosorbent assay technique. An elevated ACA level was defined as one which was greater than 3 standard deviations above the mean level for normal controls. We examined the CT findings and risk factors for stroke such as hypertension, diabetes mellitus, hyperlipidemia and cardiac disease. Laboratory data such as the platelet count, the presence of lupus anticoagulant and a biologic false-positive test for syphilis were also investigated. Among the 250 patients with infarction, IgG ACA was detected in 22 (8.8%). There was no significant difference in incidence of ACA between the patients with cerebral thrombosis and those with cerebral embolism. On CT scan, multiple cerebral infarcts were noted in 18 of the 22 patients. As regards the location of the infarct, the cerebral cortex together with the basal ganglia was more common than isolated lesions of the cortex or basal ganglia. Concerning the risk factors for stroke, hypertension was noted in 12, diabetes mellitus in 2, hyperlipidemia in 2 and cardiac disease in 2. Lupus anticoagulant and thrombocytopenia were not detected in any of the cases. A biologic false-positive test for syphilis was observed in one case. Dementia was present in 12 of the 22 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
我们对一系列无系统性红斑狼疮(SLE)的脑梗死患者进行了抗心磷脂抗体(ACA)检测。评估了1988年至1990年期间到我们诊所就诊的250例非SLE脑梗死患者的临床和实验室数据。采用酶联免疫吸附测定技术测量抗心磷脂IgG抗体浓度。ACA水平升高定义为高于正常对照组平均水平3个标准差以上。我们检查了CT表现以及中风的危险因素,如高血压、糖尿病、高脂血症和心脏病。还研究了血小板计数、狼疮抗凝物的存在以及梅毒生物学假阳性试验等实验室数据。在250例梗死患者中,22例(8.8%)检测到IgG ACA。脑血栓形成患者和脑栓塞患者的ACA发生率无显著差异。CT扫描显示,22例患者中有18例存在多发性脑梗死。就梗死部位而言,大脑皮质与基底节同时受累比单纯皮质或基底节病变更为常见。关于中风的危险因素,12例有高血压,2例有糖尿病,2例有高脂血症,2例有心脏病。所有病例均未检测到狼疮抗凝物和血小板减少症。1例观察到梅毒生物学假阳性试验。22例患者中有12例存在痴呆。(摘要截选至250字)