Bokarewa M I, Bremme K
Blood Coagulation Research, Department of Laboratory Medicine, Karolinska Hospital, Stockholm, Sweden. mabo@fafner (mb.ks.se)
Eur J Haematol. 1998 Jul;61(1):21-6. doi: 10.1111/j.1600-0609.1998.tb01056.x.
The composition of antibodies against phospholipids (PLa) was analysed in 54 PLa-positive thrombophilic women, different in the factor V genotype (Arg506-Gln mutation carriers, n=23; and noncarriers, n=31). The presence of antibodies against prothrombin was also studied. The incidence of cardiolipin antibodies (CLa) and lupus anticoagulant (LA) activity was similar among the carriers and noncarriers, while phosphatidylserine antibodies (PSa) were often the only PLa detected in the carriers of the mutation (7/23 vs. 2/31; chi2=5.47, p<0.05). Antibodies against prothrombin were found in 11 of 54 patients. They segregated with PSa (8/19 vs. 3/35; chi2=8.54, p<0.025), but were equally distributed between carriers and noncarriers. The analysis of nAPC-ratio in patients with different PLa showed that it was consistently lower in the mutation carriers in whom none of the PLa caused further suppression. The noncarrier group positive for LA in several assays was associated with a reduction of nAPC-ratio (0.82+/-0.25 vs. 1.12+/-0.22, p<0.05). Our findings indicate that PLa contributing to the development of APC resistance are restricted to those possessing LA activity.
对54名磷脂抗体（PLa）阳性的易栓症女性进行了抗磷脂抗体组成分析，这些女性的凝血因子V基因型不同（506位精氨酸突变为谷氨酰胺的携带者，n = 23；非携带者，n = 31）。还研究了抗凝血酶原抗体的存在情况。在携带者和非携带者中，心磷脂抗体（CLa）和狼疮抗凝物（LA）活性的发生率相似，而磷脂酰丝氨酸抗体（PSa）往往是突变携带者中唯一检测到的PLa（7/23对2/31；χ2 = 5.47，p<0.05）。54名患者中有11名发现了抗凝血酶原抗体。它们与PSa相关（8/19对3/35；χ2 = 8.54，p<0.025），但在携带者和非携带者中分布均匀。对不同PLa患者的蛋白C活化剂比值（nAPC-ratio）分析表明，在突变携带者中该比值始终较低，且没有一种PLa能进一步抑制该比值。在几种检测中LA呈阳性的非携带者组与nAPC-比值降低相关（0.82±0.25对1.12±0.22，p<0.05）。我们的研究结果表明，导致蛋白C抵抗发生的PLa仅限于具有LA活性的那些抗体。
