抗心磷脂抗体与系统性红斑狼疮患者凝血指标相关性研究  

Correlation between anticardiolipin antibodies and coagulation system in patients with systemic lupus erythematosus

作　　者：宋佳敏[1] 达展云[1] SONG Jiamin;DA Zhanyun(Department of Rheumatology,the Affiliated Hospital of Nantong University,Nantong 226001)

机构地区：[1]南通大学附属医院风湿免疫科,南通226001

出　　处：《南通大学学报（医学版）》2018年第3期181-184,共4页Journal of Nantong University(Medical sciences)

基　　金：江苏省卫计委资助课题(H201623);南通市科技计划项目(HS2016003);江苏省普通高校研究生科研创新计划项目(YKC16101)

摘　　要：目的 :探讨抗心磷脂抗体(anticardiolipin antibody,ACA)对系统性红斑狼疮(systemic lupus erythematosus,SLE)患者凝血纤溶系统的影响及其临床意义。方法 :采用酶联免疫吸附试验检测129例SLE患者血清ACA水平,同时对血小板计数、抗β2糖蛋白1(beta2 glycoprotein 1,β2GP1)抗体水平和凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、D-二聚体、纤维蛋白原降解产物(fibrinogen degradation products,FDP)等凝血和纤溶系统指标进行测定,并计算系统性红斑狼疮疾病活动度积分(systemic lupus erythematosus disease activity index,SLEDAI)。根据ACA水平分为ACA阳性组和ACA阴性组,比较两组间抗β2GP1抗体水平、血小板水平、凝血纤溶指标、血栓及反复流产发生率、SLEDAI的差异。结果:129例SLE患者中,ACA阳性44例(34.1%),ACA阳性组血小板计数[(155.64±80.48)×109/L]显著低于ACA阴性组[(189.64±89.94)×109/L](P<0.05),抗β2GP1抗体、APTT水平[(28.39±45.57)RU/m L、(30.88±6.64)s]显著高于ACA阴性组[(12.67±21.11)RU/m L、(28.09±5.95)s](均P<0.05)。两组PT、D-二聚体、FDP、SLEDAI差异均无统计学意义(均P>0.05)。结论:ACA阳性的SLE患者APTT延长、血小板减少、反复自发性流产发病率增加,临床工作中应常规检测SLE患者抗磷脂抗体水平并监测凝血功能。Objective： To investigate the effect of anticardiolipin antibody（ACA） on coagulation and fibrinolytic system in patients with systemic lupus erythematosus（SLE） and its clinical significance. Methods： The platelet count, anti-beta2 glycoprotein 1（ β2 GP1） antibody level and coagulation and fibrinolytic system indexes such as prothrombin time（ PT）, activated partial thromboplastin time（ APTT）, D-dimer, fibrinogen degradation products（ FDP） were measured. And the systemic lupus erythematosus disease activity index（SLEDAI） were calculated. The patients were divided into ACA positive group and ACA negative group according to the level of ACA. The differences of anti-β2 GP1 antibody level, platelet count, coagulation and fibrinolysis indexs, thrombosis and recurrent miscarriage events between the two groups were compared. Results： Among 129 SLE patients, 44 were positive for ACA, the positive rate was 34.1%. The average platelet count in ACA positive group was（155.64 ±80.48）×109/L, which was significantly lower than that in ACA negative group（189.64 ±89.94） ×109/L（P〈0.05）. The average level of anti-β2 GP1 and APTT in ACA positive group were（28.39±45.57） RU/m L and（30.88±6.64） s, which were significantly higher than that in ACA negative group [（12.67 ±21.11） RU/m L and（28.09 ±5.95） s]（P〈0. 05）. There were no significant differences between the two groups of PT, D-dimer, FDP and SLEDAI（ P〈0. 05）. Conclusions： APTT prolongation,thrombocytopenia and recurrent spontaneous abortion in ACA-positive SLE patients are increased. Antiphospholipid antibody should be routinely tested in SLE patients. The coagulation and fibrinolysis system indexes of SLE patients should be jointly and routinely tested with APL in clinical practice.

关 键 词：系统性红斑狼疮 抗心磷脂抗体 凝血功能 

分 类 号：R593.24[医药卫生—内科学]