Rote N S, Dostal-Johnson D, Branch D W
Reproductive Immunology Laboratory, Foundation For Blood Research, Scarborough, Maine.
Am J Obstet Gynecol. 1990 Aug;163(2):575-84. doi: 10.1016/0002-9378(90)91201-m.
Concordance was determined among the presence of the lupus anticoagulant measured by prolongation of the activated partial thromboplastin time and IgG and IgM antibodies against phosphatidylserine and cardiolipin in 47 patients selected for study because of histories of recurrent spontaneous pregnancy loss and a positive test for at least one antiphospholipid antibody. Forty-five of 47 patients (96%) had a prolonged activated partial thromboplastin time, ranging from 46 to 150 seconds. Elevated levels of IgG antiphosphatidylserine antibodies and IgM antiphosphatidylserine antibodies were present in 41 (87%) and in 19 (40%) of samples, respectively. Antibodies against cardiolipin were less commonly observed; IgG anticardiolipin antibodies in only 32 (68%) of 47 samples and IgM anticardiolipin antibodies in 15 (36%) of 42 samples. Neither the level of IgG antiphosphatidylserine antibodies nor the level of IgG anticardiolipin antibodies correlated well with the degree of prolongation of coagulation in the activated partial thromboplastin time (R = 0.312, p = 0.032 for IgG antiphosphatidylserine antibodies versus activated partial thromboplastin time; R = 0.251, p = 0.088 for IgG anticardiolipin antibodies versus activated partial thromboplastin time). Concordance with the activated partial thromboplastin time, however, was observed in 41 (87%) samples for IgG antiphosphatidylserine antibodies and in only 32 (68%) samples for IgG anticardiolipin antibodies. Our conclusion is that the antiphosphatidylserine assay correlates best, although not totally, with the presence of lupus anticoagulant and that the antiphosphatidylserine assay is more sensitive than testing for anticardiolipin.
在47例因反复自然流产病史且至少一种抗磷脂抗体检测呈阳性而入选研究的患者中，通过活化部分凝血活酶时间延长来测定狼疮抗凝物的存在情况，并检测针对磷脂酰丝氨酸和心磷脂的IgG及IgM抗体，以确定它们之间的一致性。47例患者中有45例（96%）活化部分凝血活酶时间延长，范围为46至150秒。分别有41份样本（87%）和19份样本（40%）检测到IgG抗磷脂酰丝氨酸抗体和IgM抗磷脂酰丝氨酸抗体水平升高。针对心磷脂的抗体较少见；47份样本中仅有32份（68%）检测到IgG抗心磷脂抗体，42份样本中有15份（36%）检测到IgM抗心磷脂抗体。IgG抗磷脂酰丝氨酸抗体水平和IgG抗心磷脂抗体水平均与活化部分凝血活酶时间的凝血延长程度无良好相关性（IgG抗磷脂酰丝氨酸抗体与活化部分凝血活酶时间相比，R = 0.312，p = 0.032；IgG抗心磷脂抗体与活化部分凝血活酶时间相比，R = 0.251，p = 0.088）。然而，41份样本（87%）的IgG抗磷脂酰丝氨酸抗体与活化部分凝血活酶时间一致，而IgG抗心磷脂抗体仅有32份样本（68%）与活化部分凝血活酶时间一致。我们的结论是，抗磷脂酰丝氨酸检测与狼疮抗凝物的存在相关性最佳，尽管并非完全相关，并且抗磷脂酰丝氨酸检测比检测抗心磷脂更敏感。
