Liozon F, Jauberteau-Marchan M O, Boutros-Toni F, Barrier J H, Dupond J L, Roblot P, Liozon E, Delaire L, Vidal E
Service de Médecine Interne, CHU, Limoges.
Ann Med Interne (Paris). 1995;146(8):541-7.
A prospective study, including 86 patients with giant cell arteritis proven by temporal artery biopsies, was performed to determine the prevalence of anticardiolipin antibodies, the antibody isotype, the relationship of antibodies to ischemic involvement and their evolution during corticosteroid treatment. Controls were obtained from 50 subjects without vasculitis or autoimmune disorders. Before treatment, 50% of patients' sera contained anti-cardiolipin antibodies (vs 8% in controls, p < 0.0001). These antibodies were IgG-ACL in 36% of patients and IgM-ACL in 17% of patients (vs respectively, 4% and 2% in controls). No significant association was observed between the incidence of ischemic ocular complications and the levels of anti-cardiolipin antibodies. During corticosteroid treatment, the level of anti-cardiolipin antibodies, mostly IgG class, decreased to become negative in 2 months. An increase of these antibodies was observed with the occurrence of relapses in four patients, after the end of corticosteroid therapy. The significance of IgG and IgM antibodies is different in giant cell arteritis. IgG antibodies may be markers of the course of this vasculitis.
一项前瞻性研究纳入了86例经颞动脉活检证实为巨细胞动脉炎的患者，旨在确定抗心磷脂抗体的患病率、抗体亚型、抗体与缺血性病变的关系以及它们在皮质类固醇治疗期间的变化情况。对照组来自50名无血管炎或自身免疫性疾病的受试者。治疗前，50%患者的血清含有抗心磷脂抗体（对照组为8%，p<0.0001）。这些抗体在36%的患者中为IgG-ACL，在17%的患者中为IgM-ACL（对照组分别为4%和2%）。未观察到缺血性眼部并发症的发生率与抗心磷脂抗体水平之间存在显著关联。在皮质类固醇治疗期间，抗心磷脂抗体水平（主要为IgG类）下降，在2个月内转为阴性。在4例患者中，皮质类固醇治疗结束后复发时观察到这些抗体水平升高。在巨细胞动脉炎中，IgG和IgM抗体的意义不同。IgG抗体可能是这种血管炎病程的标志物。
