抗心磷脂抗体在狼疮肾炎患者中的临床意义(英文)  

Clinical significance of anti-cardiolipin antibodies in patients with lupus nephritis

作　　者：李博[1] 叶志中[1] 胡秋侠[1] 尹志华[1] 汪迅[1] 张丽君[1] 李剑松[1] 庄俊汉[1] 

机构地区：[1]深圳市第四人民医院香蜜湖风湿病分院,广东医学院深圳风湿病研究所,广东省深圳市518040

出　　处：《中国组织工程研究与临床康复》2008年第11期2193-2196,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：深圳市医学重点学科建设基金资助项目(2005C10)~~

摘　　要：背景:以往的研究表明,在系统性红斑狼疮及抗磷脂抗体综合征患者中,升高的抗心磷脂抗体滴度与血管血栓形成、血小板减少及反复流产的发生明显相关。但有关抗心磷脂在狼疮性肾炎患者中的临床意义的研究报道却不完全统一。目的:探讨抗心磷脂抗体在中国狼疮性肾炎患者中的阳性率及临床意义。设计:前瞻性单一样本的随访观察。单位:深圳市第四人民医院香蜜湖风湿病分院,广东医学院深圳风湿病研究所。对象:选择2001-03/2003-10于深圳市第四医院香蜜湖风湿病分院风湿科门诊就诊或住院的狼疮性肾炎患者97例。均符合美国风湿病学学会(ACR)1997年修订的狼疮性肾炎的诊断和分类标准。纳入对象均对检测项目知情同意。方法:记录患者入院后的临床资料和辅助检查结果。应用酶联免疫吸收法检测患者血清中的抗心磷脂抗体,阳性判断标准为测定值超过100U/mL。大剂量口服强的松联合环磷酰胺静脉冲击治疗以诱导缓解,然后逐渐将强的松减量,将环磷酰胺换成硫唑嘌呤以维持疗效。同时使用其它药物控制可能合并的高血压、高血脂与关节痛等症状。每半年对纳入对象进行定期随访,记录狼疮性肾炎患者的临床资料及实验室检查结果,共3年。主要观察指标:患者的性别、年龄、系统性红斑狼疮病情活动指数、血栓形成、病理妊娠等临床表现及肾功能等实验室检查结果。结果:实验共纳入狼疮性肾炎患者97例,83例进入结果分析,14例脱落。在入选的97例患者中,其发病后被确诊时抗心磷脂抗体阳性者有38例(39%),高血压,血小板减少及雷诺现象在伴有抗心磷脂抗体阳性的狼疮性肾炎患者中更为常见。IgG型抗心磷脂抗体阳性狼疮性肾炎患者更易发生血管血栓形成;抗心磷脂抗体阳性狼疮性肾炎患者更易发生流产、早产和死胎以及慢性肾功能不全恶化。结论:抗心�BACKGROUND： Previous studies have documented that, the increase of anti-cardiolipin （aCL） antibody titer has an obvious positive relationship with the vascular thrombosis, thrombocytopenia and repeated abortion in the patients with systemic lupus erythematosus and antiphospholipid syndrome, but there is little information on the aCL antibodies in lupus nephritis （LN）. OBJECTIVE： To ascertain the prevalence and significance of aCL antibodies in Chinese patients with LN. DESIGN： Prospective follow-up study of one sample. SETTING： Department of Rheumatology in Xiangmihu Branch of Shenzhen Fourth People＇s Hospital, Shenzhen Institute of Rheumatology in Guangdong Medical College. PARTICIPANTS： The study was performed in 97 LN patients consecutively recruited in the Department of Rheumatology in Xiangmihu Branch of Shenzhen Fourth People＇s Hospital between March 2001 and October 2003. All the included patients met the revised criteria of American College of Rheumatology for the diagnosis and classification of LN. And they all knew the fact saying yes. METHODS： The clinical data and auxiliary examination result were recorded when hospitalization. The aCL antibodies were measured by the enzyme-linked immunosorbent assay, and were considered as positive if over 100 U/mL. High-dose oral administration of prednisone combined with cyclophosphamide intravenous pulse therapy were applied for inducing release. The curative effect was remained by using azathioprine and prednisone at a decreasing dose. Meanwhile the complications such as hypertension, hyperlipemia and arthralgia were prevented by drugs. All the patients had routine visits at six-month intervals for a total of 3 years. Clinical and serologic manifestations of patients with LN were tested and recorded regularly. MAIN OUTCOME MEASURES： Gender, age, systemic lupus erythematosus disease activity index, clinical manifestations, vascular thrombosis, pregnancy outcome and renal function. RESULTS： All the 97 LN patients were inclu

关 键 词：抗心磷脂抗体 狼疮性肾炎 阳性率 临床意义 

分 类 号：R593.242[医药卫生—内科学]