Lee Hye Ryun, Kim Ji-Eun, Ha Soo-Hyun, Kim Hyun Kyung, Park Seonyang, Cho Han-Ik
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
Korean J Lab Med. 2009 Dec;29(6):497-504. doi: 10.3343/kjlm.2009.29.6.497.
The presence of lupus anticoagulants (LA) is a strong risk factor for thrombosis in antiphospholipid syndrome. We investigated the usefulness of addition of silica clotting time (SCT) to the pre-existing dilute Russell's viper venom test (dRVVT) for detection of LA. Also, we analyzed differences in the thrombotic features and the characteristics of antiphospholipid antibodies between dRVVT and SCT.
A total of 167 patients positive for LA or anti-cardiolipin (anti-CL) antibody and 76 healthy controls were enrolled. The dRVVT and SCT were used for detection of LA. Anti-CL, anti-beta2-glycoprotein I (anti-beta2 GPI) and anti-prothrombin (anti-PT) antibodies were measured using commercial ELISA kits.
In detection of thrombosis, the sensitivity of the combined test of SCT and dRVVT was 56.4%, which was higher than that of dRVVT alone (46.2%) or SCT alone (23.1%). The specificity of the combined test (80.9%) was comparable to that of dRVVT (81.9%). Also, odds ratio for predicting thrombosis was higher in the combined test than in dRVVT or SCT alone. When normalized LA ratio of the two tests was compared, the group of patients with higher ratio of SCT showed significantly higher prevalence of recurrent abortion and higher positivity of IgG types of anti-CL, anti-beta2 GPI and anti-PT than the group with higher ratio of dRVVT.
Addition of SCT to dRVVT can improve the detection sensitivity of thrombosis in LA test. And the high normalized LA ratio of SCT may be a useful parameter for detection of recurrent abortion.
狼疮抗凝物(LA)的存在是抗磷脂综合征中血栓形成的一个重要危险因素。我们研究了在现有的稀释蝰蛇毒时间(dRVVT)基础上增加硅土凝血时间(SCT)用于检测LA的有效性。此外,我们分析了dRVVT和SCT在血栓形成特征及抗磷脂抗体特性方面的差异。
共纳入167例LA或抗心磷脂(抗CL)抗体阳性患者及76例健康对照。采用dRVVT和SCT检测LA。使用商用ELISA试剂盒检测抗CL、抗β2糖蛋白I(抗β2 GPI)和抗凝血酶原(抗PT)抗体。
在血栓形成检测中,SCT与dRVVT联合检测的敏感性为56.4%,高于单独的dRVVT(46.2%)或单独的SCT(23.1%)。联合检测的特异性(80.9%)与dRVVT(81.9%)相当。此外,联合检测预测血栓形成的优势比高于单独的dRVVT或SCT。比较两种检测方法的标准化LA比值时,SCT比值较高的患者组复发性流产的患病率显著更高,且IgG型抗CL、抗β2 GPI和抗PT的阳性率高于dRVVT比值较高的组。
在dRVVT基础上增加SCT可提高LA检测中血栓形成的检测敏感性。并且SCT的高标准化LA比值可能是检测复发性流产的一个有用参数。