Picillo U, Migliaresi S, Marcialis M R, Ferruzzi A M, Tirri G
Institute of Clinical Medicine, Rheumatology Unit, Faculty of Medicine 2nd University of Naples, Italy.
Clin Rheumatol. 1997 Jun;16(4):378-83. doi: 10.1007/BF02242455.
Associations of antinuclear (ANA) and anticardiolipin (aCL) antibodies with clinical manifestations were analyzed in patients with systemic sclerosis (SSc). We studied 105 SSc patients: 28 had limited cutaneous SSc (lcSSc) involving fingers; 36 had intermediate cutaneous SSc involving limbs and face; 33 had diffuse cutaneous SSc (dcSSc) involving the trunk; 8 had a sclerosis sine scleroderma. Clinical manifestations and instrumental and laboratory findings were considered to calculate a disease score. Serum anticentromere (ACA), anti-topoisomerase I (anti-topo I) antibodies, and aCL (of IgG/IgA/IgM classes) were investigated by conventional methods. ACA positive patients (n=18), compared to ACA negative, showed higher prevalence of IcSSc (p < 0.001), lower prevalence of restrictive ventilatory defect (p=0.006), and lower disease score (p=0.008). Anti-topo I positive patients (n= 70) showed lower prevalence of lcSSc (p =0.001) compared to anti-topo I negative. In aCL positive patients (n=27) widespread skin and visceral involvement occurred more frequently than in aCL negative. The association with myocardial ischemia or necrosis (p=0.010) was significant. Occurrence of ACA excluded the coexistence of anti-topo I (p < 0.001), and aCL (p=0.037). aCL positive patients showed higher disease score in comparison with ACA positive patients (p=0.003). In conclusion ACA recognize patients with a mild disease. aCL in contrast to ACA are better than anti-topo I in recognizing the most severe pictures of SSc.
分析了抗核（ANA）和抗心磷脂（aCL）抗体与系统性硬化症（SSc）患者临床表现之间的关联。我们研究了105例SSc患者：28例为局限型皮肤SSc（lcSSc），累及手指；36例为中间型皮肤SSc，累及四肢和面部；33例为弥漫型皮肤SSc（dcSSc），累及躯干；8例为无硬皮病的硬化症。考虑临床表现、仪器检查和实验室检查结果来计算疾病评分。采用传统方法检测血清抗着丝点（ACA）、抗拓扑异构酶I（抗topo I）抗体以及IgG/IgA/IgM类别的aCL。与ACA阴性患者相比，ACA阳性患者（n = 18）中lcSSc的患病率更高（p < 0.001），限制性通气功能障碍的患病率更低（p = 0.006），疾病评分更低（p = 0.008）。与抗topo I阴性患者相比，抗topo I阳性患者（n = 70）中lcSSc的患病率更低（p = 0.001）。在aCL阳性患者（n = 27）中，皮肤和内脏广泛受累的情况比aCL阴性患者更常见。与心肌缺血或坏死的关联具有显著性（p = 0.010）。ACA阳性排除了抗topo I（p < 0.001）和aCL（p = 0.037）同时存在的情况。与ACA阳性患者相比，aCL阳性患者的疾病评分更高（p = 0.003）。总之，ACA可识别病情较轻的患者。与ACA相比，aCL在识别最严重的SSc病例方面优于抗topo I。
