Pruzanski W, Lee P, Stefanski E, Sternby B, Vadas P
Inflammation Research Group, University of Toronto, Canada.
J Rheumatol. 1990 Sep;17(9):1182-6.
Phospholipase A2 (PLA2), total and pancreatic, were quantitated in 91 sera of patients with systemic sclerosis (SSc). The mean total PLA2 of 216 +/- 161 U/ml (SD) was significantly lower (p less than 0.001) than in controls (317 +/- 128 U/ml). In 55 of 91 patients (60%) PLA2 was more than 1 SD and in 6 (7%) more than 2 SD below the normal mean. Serum pancreatic PLA2 was also significantly lower in SSc. The prevalence of low serum total PLA2 was significantly greater (p less than 0.001) than in healthy adults, or in patients with rheumatoid arthritis, systemic lupus erythematosus or vasculitis. Repeat assays of PLA2 activity in 10 patients with SSc documented persistence of low PLA2. Among 76 patients with SSc with complete clinical and laboratory assessment, there were 48 with low and 28 with normal (or slightly elevated) PLA2. These 2 groups showed no differences in disease manifestation or therapy. The group with low serum PLA2 had lower erythrocyte sedimentation rates (p less than 0.0005) and lower neutrophil (p less than 0.05) and monocyte counts (p less than 0.025) in the peripheral blood. The finding of low serum PLA2 activity adds to the spectrum of arachidonic acid pathway abnormalities associated with SSc, and may in part be related to the paucity of inflammatory changes observed in this disease.
对91例系统性硬化症（SSc）患者的血清进行了总磷脂酶A2（PLA2）和胰腺磷脂酶A2的定量检测。患者的总PLA2平均水平为216±161 U/ml（标准差），显著低于对照组（317±128 U/ml，p<0.001）。91例患者中有55例（60%）的PLA2水平低于正常均值1个标准差以上，6例（7%）低于正常均值2个标准差以上。SSc患者的血清胰腺PLA2水平也显著降低。血清总PLA2水平偏低的患病率显著高于健康成年人、类风湿关节炎患者、系统性红斑狼疮患者或血管炎患者（p<0.001）。对10例SSc患者的PLA2活性进行重复检测，结果显示PLA2水平持续偏低。在76例接受了全面临床和实验室评估的SSc患者中，48例PLA2水平偏低，28例PLA2水平正常（或略有升高）。这两组在疾病表现或治疗方面无差异。血清PLA2水平偏低的患者外周血红细胞沉降率较低（p<0.0005），中性粒细胞（p<0.05）和单核细胞计数较低（p<0.025）。血清PLA2活性偏低这一发现扩展了与SSc相关的花生四烯酸途径异常的范围，可能部分与该疾病中观察到的炎症变化较少有关。
