Adler Y, Finkelstein Y, Zandeman-Goddard G, Blank M, Lorber M, Lorber A, Faden D, Shoenfeld Y
Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel.
Lupus. 1995 Aug;4(4):309-13. doi: 10.1177/096120339500400413.
This study was undertaken to determine if there is an association between increased titers of five different antiphospholipid antibodies (aPLA) in young patients' sera and the occurrence of acute myocardial infarction (AMI). Antibodies to anticardiolipin (aCL), anti-phosphatidylserine (aPS), antiphosphatidylinositol (aPI), anti-phosphatidylcholine (aPC), and anti-phosphatidylethanol amine (aPEA) were measured in 214 patients (102 patients, 102 healthy controls and 10 patients with antiphospholipid syndrome). These antibodies were measured twice (within 4h of onset of acute myocardial ischemic chest pain and 3 months after the myocardial infarction) by enzyme linked immunosorbent assay (ELISA). Elevated titers of four different aPLA were detected in 6.9% of all patients with AMI on hospitalization. Titers of aPLA in AMI were elevated in the younger age group < 50 years old (P < 0.001) and in men only (not statistically significant). No correlation was found between the presence of aPLA and cardiovascular risk factors (smoking, hypertension, diabetes mellitus and hyper-cholesterolemia). Three of the seven patients with increased titers of aPLA did not have any other cardiovascular risk factors. The titers of aPLA were within normal range 3 months after AMI. Evidence of significantly elevated titers of different aPLA at the early stage of AMI suggests that these autoantibodies are present before the AMI and are not secondary to them. The disappearance of the elevated aPLA 3 months after AMI may be due to an absorption effect or possibly a cyclic phenomenon similarly found in other autoimmune diseases. aPLA may be an additional risk factor for AMI, and should especially be considered in a patient of the younger age group without apparent cardiovascular risk factors.
本研究旨在确定年轻患者血清中五种不同抗磷脂抗体（aPLA）滴度升高与急性心肌梗死（AMI）的发生之间是否存在关联。在214例患者（102例AMI患者、102例健康对照者和10例抗磷脂综合征患者）中检测了抗心磷脂抗体（aCL）、抗磷脂酰丝氨酸抗体（aPS）、抗磷脂酰肌醇抗体（aPI）、抗磷脂酰胆碱抗体（aPC）和抗磷脂酰乙醇胺抗体（aPEA）。通过酶联免疫吸附测定（ELISA）对这些抗体进行了两次检测（急性心肌缺血性胸痛发作后4小时内和心肌梗死后3个月）。所有AMI患者中，6.9%在住院时检测到四种不同aPLA的滴度升高。AMI患者中，年龄＜50岁的年轻组aPLA滴度升高（P＜0.001），且仅男性升高（无统计学意义）。未发现aPLA的存在与心血管危险因素（吸烟、高血压、糖尿病和高胆固醇血症）之间存在相关性。aPLA滴度升高的7例患者中有3例没有任何其他心血管危险因素。AMI后3个月，aPLA滴度在正常范围内。AMI早期不同aPLA滴度显著升高的证据表明，这些自身抗体在AMI之前就已存在，并非继发于AMI。AMI后3个月aPLA升高消失可能是由于吸收效应，或者可能是在其他自身免疫性疾病中同样发现的一种周期性现象。aPLA可能是AMI的一个额外危险因素，尤其应在无明显心血管危险因素的年轻患者中予以考虑。
