Li R, Daguzan M, Vandermijnsbrugge F, Gyling M, Cantinieaux B
Acta Clin Belg. 2014 Dec;69(6):433-8. doi: 10.1179/2295333714Y.0000000060. Epub 2014 Aug 7.
The aim of our study was to evaluate the clinical values of anti-beta2 glycoprotein I antibodies (anti-beta2GPI) IgG and IgM comparing with lupus anticoagulant (LA), anticardiolipin antibodies (aCL) in the two clinical groups of antiphospholipid syndrome (APS), vascular thrombosis (VT) and pregnancy morbidity (PM).
Eighty patients who fulfilled the APS clinical criteria, VT n = 34; PM n = 40, both VT and PM n = 6 were included. LA, aCL and three anti-beta2GPI ELISA kits were tested.
Sensitivities of LA, aCL and anti-beta2GPI assays were found respectively 62, 26 and 41% in VT, and 28, 28 and 30% in PM. The sensitivity for the APS diagnosis could reach to 63% using triple tests. The presence of LA (P<0·01, OR = 4·3) or anti-beta2GPI IgG alone (P<0·05, OR = 8·4) was significantly associated with VT. IgM isotype was found more frequent in PM (92%) than in VT (57%) among all positive anti-beta2GPI cases.
Both IgG and IgM anti-beta2GPI assays were useful when clinical features of APS presented, even its standardization is ongoing. A decreased by half sensitivity of LA in PM compared with that in VT underlines the importance of adding anti-beta2GPI in PM of APS, especially IgM isotype although recent review questioned its significance.
我们研究的目的是在抗磷脂综合征（APS）的两个临床组，即血管血栓形成（VT）和妊娠并发症（PM）中，评估抗β2糖蛋白I抗体（抗β2GPI）IgG和IgM与狼疮抗凝物（LA）、抗心磷脂抗体（aCL）相比的临床价值。
纳入80例符合APS临床标准的患者，其中VT组34例；PM组40例，VT和PM两组均有的6例。检测LA、aCL以及三种抗β2GPI ELISA试剂盒。
在VT组中，LA、aCL和抗β2GPI检测的敏感性分别为62%、26%和41%，在PM组中分别为28%、28%和30%。三联检测对APS诊断的敏感性可达63%。单独存在LA（P<0.01，OR = 4.3）或抗β2GPI IgG（P<0.05，OR = 8.4）与VT显著相关。在所有抗β2GPI阳性病例中，发现IgM同种型在PM组（92%）中比在VT组（57%）中更常见。
当出现APS临床特征时，IgG和IgM抗β2GPI检测均有用，尽管其标准化仍在进行中。与VT组相比，PM组中LA的敏感性降低了一半，这突出了在APS的PM组中添加抗β2GPI的重要性，尤其是IgM同种型，尽管最近的综述对其意义提出了质疑。
