狼疮妊娠中血管损伤的标志物。

Markers of vascular damage in lupus pregnancy.

作者信息

Direskeneli H, Buchanan N M, Khamashta M A, Keser G, D'Cruz D, Hughes G R

机构信息

Lupus Arthritis Research Unit, Rayne Institute, St Thomas' Hospital, London, United Kingdom.

出版信息

Clin Exp Rheumatol. 1997 Sep-Oct;15(5):535-9.

PMID:9307862

Abstract

OBJECTIVE

To study serum levels of von Willebrand factor antigen (vWF:Ag) and anti-endothelial cell antibodies (AECA) in pregnancies with systemic lupus erythematosus (SLE) compared to healthy pregnancies and to evaluate their correlation with disease activity and fetal outcome.

METHODS

Twenty-four patients with SLE were compared with 26 healthy pregnancies. vWF:Ag and AECA levels were measured by ELISA.

RESULTS

In lupus pregnancies vWF:Ag and AECA levels were significantly elevated compared to healthy pregnancies (vWF:Ag: 255 +/- 160%, 10/24 positive vs 135 +/- 59%, 1/26 positive, p = 0.006; AECA Binding Index: 36 +/- 29%, 5/24 positive vs 17 +/- 16%, 1/26 positive, p = 0.002). When samples taken during follow-up were evaluated, vWF:Ag was positive in 21/27 (78%) of the samples during exacerbations compared to 4/25 (16%) in remission. Only 5/27 (19%) of the samples during exacerbations and none during remission were positive for AECA. Samples during three pregnancy failures were positive for vWF:Ag, but not for AECA. Of the 13 samples taken from the mothers of 4 babies with neo-natal lupus, 10 were positive for vWF:Ag and three for AECA. No correlations of anti-cardiolipin antibodies (aCL) were seen either with vWF:Ag or AECA titres.

CONCLUSION

Compared to healthy pregnancies, vWF:Ag and AECA levels are increased in lupus pregnancies. vWF:Ag levels also correlated with active disease.

摘要

目的

研究系统性红斑狼疮（SLE）妊娠患者血清血管性血友病因子抗原（vWF:Ag）和抗内皮细胞抗体（AECA）水平，并与正常妊娠进行比较，评估其与疾病活动度及胎儿结局的相关性。

方法

将24例SLE患者与26例正常妊娠者进行比较。采用酶联免疫吸附测定法（ELISA）检测vWF:Ag和AECA水平。

结果

与正常妊娠相比，狼疮妊娠患者的vWF:Ag和AECA水平显著升高（vWF:Ag：255±160%，24例中有10例阳性，而正常妊娠组为135±59%，26例中有1例阳性，p = 0.006；AECA结合指数：36±29%，24例中有5例阳性，正常妊娠组为17±16%，26例中有1例阳性，p = 0.002）。对随访期间采集的样本进行评估时，病情加重期27份样本中有21份（78%）vWF:Ag呈阳性，缓解期25份样本中有4份（16%）呈阳性。病情加重期27份样本中只有5份（19%）AECA呈阳性，缓解期则无阳性样本。3例妊娠失败患者的样本vWF:Ag呈阳性，但AECA为阴性。在4例新生儿狼疮患儿母亲采集的13份样本中，10份vWF:Ag呈阳性，3份AECA呈阳性。抗心磷脂抗体（aCL）与vWF:Ag或AECA滴度均无相关性。