Buttgereit F, Grünewald T, Schüler-Maué W, Burmester G R, Hiepe F
Department of Medicine III, Rheumatology and Clinical Immunology, Charité University Hospital, Humboldt-Universität, Berlin, Federal Republic of Germany.
Clin Rheumatol. 1997 Nov;16(6):562-9. doi: 10.1007/BF02247796.
The prevalence of anticardiolipin antibodies in active systemic lupus erythematosus (SLE) was compared with that in inactive SLE and other rheumatic and non-rheumatic diseases to determine the value of these autoantibodies in monitoring rheumatic diseases. Pairs of IgG- and IgM-aCL were measured by ELISA in 173 consecutive hospitalised patients, including 141 with rheumatic diseases (18 active SLE, 21 inactive SLE, 19 rheumatoid arthritis, 13 reactive arthritis, 7 other spondyloarthropathies, 16 vasculitis, 47 other autoimmune diseases) and 32 non-rheumatic controls. A further 101 aCL pairs were determined during follow-up in 19 patients with SLE. Serum concentrations were analysed with respect to SLE activity and compared between the different patient groups. IgG- and IgM-aCL levels in excess of 10 GPL and 9 MPL respectively were considered positive. 30.6% of all patients (53/173) were found to be positive for IgG-aCL, as against only 9.8% (17/173) for IgM-aCL. IgG-aCL serum levels in active SLE differed significantly from all other groups, including inactive SLE (all p < 0.005). Median IgM-aCL levels were below the cut off point in all groups, although measurable values were obtained almost exclusively in active SLE and RA. In this study IgM-aCL measurement was of less value in monitoring rheumatic diseases. IgG-aCL positivity in SLE was associated with a significantly higher odds ratio (OR) for active disease (OR 16.0, 95% confidence interval: 2.8-90.0). The results show that disease activity in SLE was accompanied by significantly increased IgG-aCL, whereas no elevation was found in other diseases. This parameter may therefore be useful in monitoring SLE activity.
将活动性系统性红斑狼疮（SLE）患者中抗心磷脂抗体的患病率与非活动性SLE以及其他风湿性和非风湿性疾病患者的患病率进行比较，以确定这些自身抗体在监测风湿性疾病中的价值。采用酶联免疫吸附测定法（ELISA）检测了173例连续住院患者的IgG-和IgM-抗心磷脂抗体（aCL），其中包括141例风湿性疾病患者（18例活动性SLE、21例非活动性SLE、19例类风湿关节炎、13例反应性关节炎、7例其他脊柱关节病、16例血管炎、47例其他自身免疫性疾病）和32例非风湿性对照。在19例SLE患者的随访期间又检测了101对aCL。分析了血清浓度与SLE活动度的关系，并在不同患者组之间进行了比较。IgG-aCL和IgM-aCL水平分别超过10 GPL和9 MPL被视为阳性。所有患者中有30.6%（53/173）的IgG-aCL呈阳性，而IgM-aCL阳性率仅为9.8%（17/173）。活动性SLE患者的IgG-aCL血清水平与所有其他组（包括非活动性SLE）相比有显著差异（所有p<0.005）。所有组的IgM-aCL中位数水平均低于临界值，不过几乎仅在活动性SLE和类风湿关节炎患者中获得了可测量值。在本研究中，IgM-aCL检测在监测风湿性疾病方面价值较小。SLE患者中IgG-aCL阳性与活动性疾病的显著较高比值比（OR）相关（OR 16.0，95%置信区间：2.8-90.0）。结果表明，SLE疾病活动伴有IgG-aCL显著升高，而其他疾病未发现升高。因此，该参数可能有助于监测SLE活动度。
