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[系统性硬化症和雷诺病中的抗内皮细胞抗体]

[Antiendothelial antibodies in systemic scleroderma and Raynaud's disease].

作者信息

Salozhin K V, Shcherbakov A B, Nasonov E L, Kolesova N V, Romanov Iu A, Guseva N G

出版信息

Ter Arkh. 1995;67(5):54-7.

PMID:7638782
Abstract

Using ELISA on fixed endothelial hybridoma (EAhy.926) cells we investigated the occurrence of antiendothelial antibodies (AEA) in the sera from patients with scleroderma systematica (SS) (n = 70) and Raynaud's disease (RD) (n = 19). The mean IgG and IgA-AEA levels were significantly higher in the SS patients than RD patients (p < 0.001) and controls (p < 0.001). We have detected circulating IgG-AEA in 64.2% of patients with SS, 35.2% of SS sera were positive for IgA-AEA. In patients with RD, the frequency of AEA corresponded to that of the random population sample. We have found a high incidence of Raynaud's phenomenon, myositis, telangiectasia and marked digital ischaemia (digital ischemic pulp ulcers, digital scars, osteolysis and autoamputation) among AEA positive patients with SS. AEA-positive patients were characterized by high extent and severity of Raynaud's phenomenon and higher average nailfold capillary microscopy scores. No correlations were found between AEA and different clinical or laboratory parameters, including the type of scleroderma (diffuse and limited), the presence of anti-Scl-7O and anticentromere antibodies and the clinical features of SS (lungs, kidneys and heart involvement, esophageal dysfunction, calcinosis, Sjogren's syndrome). There was no significant correlation between the AEA level and patient age, extent of skin involvement (skin score). Thus, in SS, AEA is associated with a peripheral vasculopathy and represent a useful marker for the diagnosis of endothelial dysfunction.

摘要

我们使用酶联免疫吸附测定法(ELISA)检测固定的内皮杂交瘤(EAhy.926)细胞,以研究系统性硬化症(SS)患者(n = 70)和雷诺病(RD)患者(n = 19)血清中抗内皮细胞抗体(AEA)的出现情况。SS患者的平均IgG和IgA-AEA水平显著高于RD患者(p < 0.001)和对照组(p < 0.001)。我们在64.2%的SS患者中检测到循环IgG-AEA,35.2%的SS血清IgA-AEA呈阳性。在RD患者中,AEA的频率与随机人群样本的频率相当。我们发现,在AEA阳性的SS患者中,雷诺现象、肌炎、毛细血管扩张和明显的手指缺血(手指缺血性指腹溃疡、手指瘢痕、骨质溶解和自动截肢)的发生率很高。AEA阳性患者的特点是雷诺现象的程度和严重程度较高,平均甲襞毛细血管显微镜评分也较高。未发现AEA与不同临床或实验室参数之间存在相关性,包括硬皮病的类型(弥漫性和局限性)、抗Scl-7O和抗着丝点抗体的存在以及SS的临床特征(肺部、肾脏和心脏受累、食管功能障碍、钙质沉着、干燥综合征)。AEA水平与患者年龄、皮肤受累程度(皮肤评分)之间无显著相关性。因此,在SS中,AEA与外周血管病变相关,是诊断内皮功能障碍的有用标志物。

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