Espinoza L R, Jara L J, Silveira L H, Martínez-Osuna P, Zwolinska J B, Kneer C, Aguilar J L
Department of Internal Medicine, University of South Florida College of Medicine, Tampa.
Am J Med. 1991 Apr;90(4):474-8.
We studied a group of patients with polymyalgia rheumatica (PMR) with or without biopsy-proven giant cell arteritis (GCA) in order to determine the prevalence of anticardiolipin antibodies (aCL) in these disorders and their association with vascular complications.
The study consisted of 50 patients, 30 with PMR alone and 20 with associated GCA. Determinations of IgG and IgM aCL by enzyme-linked immunosorbent assay were done in the patients and in 50 age- and sex-matched healthy control subjects. We also measured von Willebrand factor (vWF) antigen, C-reactive protein, and erythrocyte sedimentation rate.
Twenty-four (48%) of the 50 patients had aCL. Eleven were positive for IgG and five for IgM, whereas eight were positive for both. In the group of patients with PMR alone, only eight (26.6%) had aCL, while 16 of 20 patients (80%) with GCA had these antibodies (p less than 0.01). In the control group, 10 of 50 patients (20%) had positive aCL, a finding that was statistically significantly different only when compared with the finding in patients with GCA (p less than 0.01). Both isotypes of aCL were seen mainly in patients with GCA, and five of these patients had severe vascular complications. Levels of vWF antigen were significantly higher in patients with GCA as compared with patients with PMR alone; however, the highest titers did not correlate with vascular complications. Erythrocyte sedimentation rate and C-reactive protein were increased but comparable in both groups.
This study demonstrates that aCL are prevalent in patients with GCA. These antibodies might imply severe vascular damage and could play an important role in the pathogenesis of the vasculopathy observed in this disease.
我们研究了一组患有风湿性多肌痛（PMR）且有或无经活检证实的巨细胞动脉炎（GCA）的患者，以确定这些疾病中抗心磷脂抗体（aCL）的患病率及其与血管并发症的关联。
该研究包括50名患者，其中30名仅患有PMR，20名患有相关的GCA。通过酶联免疫吸附测定法对患者以及50名年龄和性别匹配的健康对照者进行了IgG和IgM aCL的测定。我们还测量了血管性血友病因子（vWF）抗原、C反应蛋白和红细胞沉降率。
50名患者中有24名（48%）存在aCL。11名IgG阳性，5名IgM阳性，8名两者均阳性。在仅患有PMR的患者组中，只有8名（26.6%）存在aCL，而20名患有GCA的患者中有16名（80%）存在这些抗体（p<0.01）。在对照组中，50名患者中有10名（20%）aCL呈阳性，这一结果仅与患有GCA的患者的结果相比在统计学上有显著差异（p<0.01）。两种aCL亚型主要见于患有GCA的患者，其中5名患者有严重的血管并发症。与仅患有PMR的患者相比，患有GCA的患者的vWF抗原水平显著更高；然而，最高滴度与血管并发症无关。红细胞沉降率和C反应蛋白升高，但两组相当。
本研究表明aCL在患有GCA的患者中普遍存在。这些抗体可能意味着严重的血管损伤，并可能在该疾病中观察到的血管病变的发病机制中起重要作用。
