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磷脂酰丝氨酸/凝血酶原复合物抗体对中国患者抗磷脂综合征的诊断价值

Diagnostic value of antibodies to phosphatidylserine/prothrombin complex for antiphospholipid syndrome in Chinese patients.

作者信息

Zhu Lei, Li Chun, Liu Na, Yang Xin, Jia R L, Mu Rong, Su Yin, Li Z G

机构信息

Department of Rheumatology and Immunology, Peking University People's Hospital, 11 South Xizhimen Street, Western District, Beijing, 100044, China.

Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, 100044, China.

出版信息

Clin Rheumatol. 2017 Feb;36(2):401-406. doi: 10.1007/s10067-016-3498-0. Epub 2017 Jan 3.

Abstract

To evaluate the diagnosis value of antibodies to phosphatidylserine/prothrombin complex (aPS/PT) in patients with antiphospholipid syndrome (APS) and to determine the clinical features of APS patients with avidity of aPS/PT. Serum samples were collected from 108 APS patients. Sixty patients with pregnancy morbidity, 37 patients with thrombosis without a history of autoimmune diseases, and 89 healthy blood donors were included as the control group. The enzyme-linked immunosorbent assay (ELISA) test was performed to detect the concentration of aPS/PT, including IgG/M, IgG, and IgM forms, in the same serum sample. The chi-square (χ2) test was used to examine the difference of frequencies of antibodies in APS patients and patients with other diseases. Spearman correlation analysis was performed to investigate the relationship between aPS/PT and other clinical/laboratory parameters. aPS/PT was detectable in 68 (63.0%) of the 108 APS patients, 12 (13.2%) of the 91 disease control patients and 1 (1.1%) of the healthy controls. It was strongly correlated with the activity of lupus anticoagulant (LA) (OR 15.952, 95% CI 7.132-35.678; P < 0.001). The frequency of aPS/PT was 56.9% in anti-cardiolipid antibody (aCL)-negative, 60.5% anti-β2 glycoprotein I antibody (aβ2GPI)-negative, and 50.0% in both aCL and aβ2GPI negative APS patients. The IgG aPS/PT was significantly associated with arterial and venous thrombosis. The aPS/PT antibody could play an important role in the diagnosis of APS, especially in patients with negative aCL and aβ2GPI. It was positively related to thrombotic events in APS.

摘要

评估抗磷脂综合征(APS)患者中磷脂酰丝氨酸/凝血酶原复合物抗体(aPS/PT)的诊断价值,并确定aPS/PT亲和力的APS患者的临床特征。收集108例APS患者的血清样本。将60例有妊娠并发症的患者、37例无自身免疫性疾病病史的血栓形成患者和89名健康献血者纳入对照组。采用酶联免疫吸附测定(ELISA)法检测同一血清样本中aPS/PT的浓度,包括IgG/M、IgG和IgM形式。采用卡方(χ2)检验来检查APS患者与其他疾病患者抗体频率的差异。进行Spearman相关性分析以研究aPS/PT与其他临床/实验室参数之间的关系。108例APS患者中有68例(63.0%)可检测到aPS/PT,91例疾病对照患者中有12例(13.2%)可检测到,健康对照中有1例(1.1%)可检测到。它与狼疮抗凝物(LA)活性密切相关(OR 15.952,95%CI 7.132 - 35.678;P < 0.001)。在抗心磷脂抗体(aCL)阴性的APS患者中,aPS/PT的频率为56.9%,抗β2糖蛋白I抗体(aβ2GPI)阴性的患者中为60.5%,aCL和aβ2GPI均阴性的APS患者中为50.0%。IgG aPS/PT与动脉和静脉血栓形成显著相关。aPS/PT抗体在APS的诊断中可能起重要作用,尤其是在aCL和aβ2GPI阴性的患者中。它与APS中的血栓形成事件呈正相关。

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