系统性红斑狼疮患者获得性活化蛋白C抵抗现象与抗磷脂抗体的检测  

Relationship between phenominon of acquired activated protein C resistance and antiphospholipid antibodies in patients with systemic lupus erythematosus

作　　者：胡燕青[1] 陈方平[2] 解勤之[2] 蹇在伏[2] 王光平[2] 左晓霞[1] 吴彩玲[1] 

机构地区：[1]中南大学湘雅医院风湿科,长沙410008 [2]中南大学湘雅医院血液科,长沙410008

出　　处：《湖南医科大学学报》2001年第5期469-472,共4页Bulletin of Hunan Medical University

基　　金：国家自然科学基金资助 (编号 39830 180 )

摘　　要：目的 :通过检测系统性红斑狼疮 (SLE)患者获得性活化蛋白C抵抗 (APCR)和抗磷脂抗体的发生率 ,探讨APCR与SLE患者血栓形成的相关性 ,以及SLE患者血栓形成中 ,APCR与抗磷脂抗体的相关性。方法 :采用APC -APTT法 ,dRVVT -LA法 ,ELISA法及PCR_酶切法分别对 30例SLE患者和 30例正常对照进行APCR及狼疮抗凝物 ,抗心磷脂抗体和FVLeiden突变检测。结果 :SLE病人APCR阳性率 (14/30 ,46 .6 7% )明显高于正常对照组 (1/30 ,3.3% ,P <0 .0 0 5 )。SLE患者无一例FVLeiden突变。APCR阳性患者中血栓发生率 (6 /14,42 .85 % )明显高于APCR阴性患者 (1/16 ,6 .2 5 % ,P<0 .0 5 )。狼疮抗凝物阳性患者中血栓发生率 (6 /12 ,5 0 % )明显高于其阴性患者 (2 /18,11.1% ,P <0 .0 5 )。结论 :获得性APCR和狼疮抗凝物均是SLE患者合并血栓形成的危险因素之一 ,但获得性APCR的发生与抗磷脂抗体的存在无关 ,表明获得性APCR的发生并非抗磷脂抗体抑制蛋白C通路导致凝血异常及致血栓形成的唯一途径。Objective To determine the occurrence of activated protein C resistance (APCR), to identify APCR is associated with thrombotic events (TEs), and acquired APCR is associated with the presence of antiphospholipid antibodies (APLAs) in 30 patients with systemic lupus erythematosus (SLE). Methods Laboratory tests included dilute Russell's viper venom time assay for LA (dRVVT-LA), ELISA assay for ACL, APC sensitivity ratio, and factor V Leiden were detected by PCR-Mnl/I digestion. Results Acquired APCR was presented in 14(46.67%) of 30 patients. Factor V Leiden was not found in any patients. The incidence of TEs in the APCR positive patients was significantly higher than that in the APCR negative patients (42.85% vs6.25%, P<0.05).The incidence of TEs in the LA positive patients was also significantly higher than that in the LA negative patients (50% vs11.1%, P<0.05). Conclusions The presence of either APCR or LAs is associated with one of the risk factors of TEs (P<0.05). There is not a significant interaction between APCR and LAs in the association with TEs. Acquired APCR may not reflect the interference of LAs with the protein C pathway which may represent a mechanism of LA-associated TEs.

关 键 词：系统性红斑狼疮 抗磷脂抗体炎 血栓形成 获得性活化蛋白C抵抗 

分 类 号：R593.241[医药卫生—内科学]