系统性红斑狼疮患者抗活化蛋白C测定及其临床意义  

Activated protein C resistance identification in patients with systemic lupus erythemotosus and its clinical significance

作　　者：厉小梅[1] 李向培[1] 周志中[2] 吴竞生 单曙光[1] 

机构地区：[1]安徽省立医院风湿科,合肥230001 [2]安徽省立医院中心实验室,合肥230001

出　　处：《中华内科杂志》2000年第2期97-99,共3页Chinese Journal of Internal Medicine

摘　　要：目的　探讨系统性红斑狼疮 (SLE)患者抗活化蛋白C(APCR)现象及其临床意义。方法APCR的检测以受检血浆加入活化蛋白C(APC)活化的部分凝血活酶时间 (APTT)与未加APC的APTT的敏感比值即APC SR表示 ,当APC SR <2 0 ,为APCR阳性。结果　SLE患者APCR阳性率为5 7 4% ,明显高于正常对照组 (χ2 =16 332 ,P <0 0 0 5 ) ,APCR阳性组患者与阴性组患者的血栓形成及反复流产发生率差异有显著性 (χ2 =4 2 41,P <0 0 5 ) ,APCR与狼疮抗凝物 (LA)有显著相关 (P <0 0 2 5 ) ,与其他临床特征及自身抗体阳性率无关。结论　APCR与LA密切相关 ,抗磷脂抗体 (APL)对蛋白C系统有抑制作用 ,APCR可能是SLE患者诱发血栓的危险因素之一 ,APL抗体及APCR的检测对SLE患者并发血栓可能有预测价值。Objective To investigate the response to activated protein C (APC) and its clinical significance in patients with systemic lupus erythemotosus (SLE) Methods The response to APC was studied by an APTT based (clotting) assay on a Stago autoanalyzer and expressed as the ratio between the APTT obtained in the presence and absence of exogenous APC, APC sensitive ratio<2 indicated APC resistance Results The APC resistance was positive in 31 of 54 (57 4%) patients with SLE The presence of APCR was associated with an increased frequency of history of thromboembolic events and/or recurrent abortions (χ 2=4 241, P <0 05) The existence of lupus anticoagulant (LA) and the APCR showed significant correlation( P <0 025) APCR was not closely correlated with other clinical manifestations and autoantibody positive Conclusions This study suggests that the APC resistance is linked to the presence of LA, and APL may interfere with the activation of protein C APCR phenotype may be a major risk factor for thrombophilia in patients with SLE Detection of APL and APC SR in patients with SLE is of potential volume for predicting the thrombosis

关 键 词：系统性红斑狼疮 抗磷脂抗体 APCR 

分 类 号：R593.241[医药卫生—内科学]