狼疮抗凝集物检测在系统性红斑狼疮、原发性血小板减少症中的临床应用  

Clinical Application of Lupus Anticoagulant Level Detection in Children with Systemic Lupus Erythematosus or Idiopathic Thrombocytopenic Purpura

作　　者：滕庆[1] 何晓琥[1] 李彩凤[1] 

机构地区：[1]首都医科大学附属北京儿童医院,北京100045

出　　处：《实用儿科临床杂志》2005年第6期559-560,共2页Journal of Applied Clinical Pediatrics

基　　金：北京市自然科学基金项目资助(7032018)

摘　　要：目的通过对系统性红斑性狼疮(SLE)310例和原发性血小板减少症(ITP)249例狼疮抗凝集物(LAC)和抗心磷脂抗体亚型(aCL-IgG、IgM、IgA)的测定,研究其与SLE临床表现的关系及LAC在ITP转归中的意义。方法采用脑磷脂-白陶土法(KCCT)及校正试验检测患儿血浆LAC;采用酶联免疫吸附试验(ELISA)测定息儿血清aCL-IgG,IgM、IgA。结果SLE 组中,66.1%显示体内存在高含量LAC,其中45.9%并狼疮肾炎;46.8%aCL抗体升高,其中90.2%为IgG和(或)IgM,分别有46.9%和11.7%是狼疮并中枢神经系统及血液系统病变。ITP组105例LAC阳性患儿中36.2%经抗核抗体(ANA)检测确诊为SLE,7.6%在2个月-2.4年后发展为SLE。结论LAC和aCL抗体亚型的水平与SLE临床表现密切相关,LAC在狼疮并肾脏病变中为优势病理性自身抗体;aCL抗体亚型的水平则与狼疮性血栓性血管炎性病变有相关关系。对单纯患有ITP的患儿应进行LAC动态观察,可及早确定疾病的转归。Objective To investigate the relativity of the lupus anticoagulant（LAC）,anticadiolipin antihody（aCL） - IgG,aCL- IgM,aCL- IgA levels and clinical symptoms of systemic lupus erythematosus （SLE）, and to determine the significance of the LAC level in the prognosis of idiopathic thromhocytopenic purpura （ITP） by detecting the LAC and aCL- IgG, IgM, IgA levels in 310 children with SLE and 249 children with ITP. Methods Kadin- cephalin clotting time（KCCT） and correcting test to detect the plaanaa LAC level and to the .serum aCL- IgG, IgM, IgA levels with enzyme - linked immunosorbent assay. Results In SLE group, there were 66.1% patients with higher LAC among whom 45.9% patients suffered from lupus nephritis , aCL subantibodty level elevated in 46.8% patients （ 90.2% IgG and/or IgM） ,serum ： 46.9% and 11.7% patients suffered from central nervous system dise,xses and blood disea.ses with SLE respectively. In ITP group, 36.2% patients with LAC positive were diagnosed as SLE by detecting the serum antinuclear antibody level, and 7.6 % suffered from SLE subsequently in the period of 2 months to 2.4 years. Conclusions The LAC and aCL subantibodty levels may have an important relativity with the clinical symptorrts of SLE. The LAC is the predominant pathologic autoantihody in patients with lupus nephritis, and the aCL subantibodty（ IgM, IgG） levels were related to lupus thromhoangiitis. The LAC level of children with ITP should be monitored in order to detemline the prognosis of the disease as soon as possible.

关 键 词：狼疮抗凝集物 红斑狼疮 系统性 儿童 抗心磷脂抗体 

分 类 号：R593.241[医药卫生—内科学] R55[医药卫生—临床医学]