动态监测脑血管病患者抗心磷脂抗体及 ENA 多肽抗体的临床意义  

Clinical significance of dynamic monitoring of anticardiolipin antibody and extractable nuclear antibody in stroke patients.

作　　者：郝静[1] 韩丹春[1] 

机构地区：[1]山东医科大学附属医院神经内科

出　　处：《临床神经病学杂志》1997年第1期18-20,共3页Journal of Clinical Neurology

摘　　要：采用酶联免疫吸附法与免疫印迹法动态监测５０例脑梗塞（ＣＩ）和４０例脑出血（ＣＨ）患者的抗心磷脂抗体（ａＣＬ）及测定部分患者的ＥＮＡ多肽抗体。结果仅ＩｇＧ型ａＣＬ与ＥＮＡ多肽抗体在急性脑血管病（ＣＶＤ）患者中显著升高，两者在ＣＩ与ＣＨ组的阳性率分别为１２．０％、１２．５％与３９．０％、４３．３％，与正常对照组０．０％及１６．７％相比，Ｐ＜０．０５。ＩｇＭ型ａＣＬ在急性ＣＶＤ后一过性升高，并于第２周达到高峰，提示ＩｇＭ型ａＣＬ为获得性自身抗体。ＩｇＧ型ａＣＬ水平上升，病情恶化，水平下降则病情好转，且其发病时高水平为ＣＶＤ不良预后的危险信号，提示ＩｇＧ型ａＣＬ为致病性抗体。ＩｇＡ型ａＣＬ在急性ＣＶＤ后变化平缓，推测与ＣＶＤ的关系不大。Fifty patients with cerebral infarction and forty patients with cerebral hemorrhage underwent dynamic monitoring of anticardiolipin antibody after onset of stroke by Elisa.Simultaneously,ENA antibody was assayed by western blot.Only IgG aCL and ENA antibody differed significantly in either cerebral infarction or cerebral hemorrhage from healthy controls(12.0%、12.5% vs.0.0%,39.0%、43.3% vs.16.7%, P <0.05).IgM aCL showed a transient,rapid increase and reached its climax in the 2nd week,IgG aCl was highly indicative of prognosis,namely,the neurologic deficits would aggrevate with increased level of IgG aCL,wheras recover with decreased concentration.IgA aCL changed evenly.The results indicat that ACL and ENA antibody are closely related to CVD.IgM aCL seems to be acquired autoantibody after stroke.IgG aCL is postpulated to be pathogenic autoantibody,while IgA aCL has little to do with stroke.

关 键 词：脑梗塞 脑出血 抗心磷脂抗体 抗核抗体 

分 类 号：R743.34[医药卫生—神经病学与精神病学]