CAJ | 학술논문

目的：探讨抗β2糖蛋白Ⅰ（anti-β2-glycoprotein I，aβ2 GPI）抗体 IgA、IgM、IgG 在系统性红斑狼疮（systemic lupus erythematosus，SLE）血栓形成中的作用。方法收集确诊 SLE 患者，根据有无发生临床血栓事件分为 SLE-non-APS 组和 SLE-APS 组。选取原发性抗磷脂抗体综合征为 PAPS 组。这些患者均经实验室检测为 aβ2 GPⅠ抗体阳性，且排除血栓形成的传统危险因素。应用酶联免疫吸附试验检测各组患者 aβ2 GPI 的 IgA、IgM、IgG 3类抗体水平。SLE-APS 组＋PAPS 组患者中发生动脉血栓事件者纳入 APS-A 组，发生静脉血栓事件者纳入 APS-V 组，比较两组间上述指标。结果共纳入82例患者，SLE 患者64例，原发性 APS 患者18例（PAPS 组）。64例 SLE 患者中，SLE-non-APS 组52例，SLE-APS 组12例。SLE-APS 组＋PAPS 组共30例，其中 APS-A 组23例，APS-V 组7例。SLE-APS 组 aβ2 GPI-IgA [（1．3±0．4）×10-8 mol/L]、aβ2 GPI-IgM浓度[（1．0±0．2）×10-8 mol/L]低于 SLE-non-APS 组[aβ2 GPI-IgA：（1．8±0．9）×10-8 mol/L，aβ2 GPI-IgM：（1．5±0．7）×10-8 mol/L]（P ＜0．05），而两组 aβ2 GPI-IgG 的浓度无明显差异。SLE-APS 组与 PAPS 组患者 aβ2 GPI-IgA、aβ2 GPI-IgG、aβ2 GPI-IgM的浓度无明显差异。APS-A 组 aβ2 GPI-IgM浓度[（1．2±0．5）×10-8 mol/L]显著高于 APS-V 组[（0．7±0．1）×10-8 mol/L]（P ＜0．05），aβ2 GPI-IgG 浓度显著低于 APS-V 组[（1．4±0．3）×10-8 mol/L vs．（1．7±0．3）×10-8 mol/L]（P ＜0．05），而两组 aβ2 GPI-IgA 的浓度无明显差异。结论无论有无 SLE 基础免疫性疾病，IgG 类 aβ2 GPI 与静脉血栓形成有明显的关联性，IgM类 aβ2 GPI 与动脉血栓形成相关。
목적：탐토항β2당단백Ⅰ（anti-β2-glycoprotein I，aβ2 GPI）항체 IgA、IgM、IgG 재계통성홍반랑창（systemic lupus erythematosus，SLE）혈전형성중적작용。방법수집학진 SLE 환자，근거유무발생림상혈전사건분위 SLE-non-APS 조화 SLE-APS 조。선취원발성항린지항체종합정위 PAPS 조。저사환자균경실험실검측위 aβ2 GPⅠ항체양성，차배제혈전형성적전통위험인소。응용매련면역흡부시험검측각조환자 aβ2 GPI 적 IgA、IgM、IgG 3류항체수평。SLE-APS 조＋PAPS 조환자중발생동맥혈전사건자납입 APS-A 조，발생정맥혈전사건자납입 APS-V 조，비교량조간상술지표。결과공납입82례환자，SLE 환자64례，원발성 APS 환자18례（PAPS 조）。64례 SLE 환자중，SLE-non-APS 조52례，SLE-APS 조12례。SLE-APS 조＋PAPS 조공30례，기중 APS-A 조23례，APS-V 조7례。SLE-APS 조 aβ2 GPI-IgA [（1．3±0．4）×10-8 mol/L]、aβ2 GPI-IgM농도[（1．0±0．2）×10-8 mol/L]저우 SLE-non-APS 조[aβ2 GPI-IgA：（1．8±0．9）×10-8 mol/L，aβ2 GPI-IgM：（1．5±0．7）×10-8 mol/L]（P ＜0．05），이량조 aβ2 GPI-IgG 적농도무명현차이。SLE-APS 조여 PAPS 조환자 aβ2 GPI-IgA、aβ2 GPI-IgG、aβ2 GPI-IgM적농도무명현차이。APS-A 조 aβ2 GPI-IgM농도[（1．2±0．5）×10-8 mol/L]현저고우 APS-V 조[（0．7±0．1）×10-8 mol/L]（P ＜0．05），aβ2 GPI-IgG 농도현저저우 APS-V 조[（1．4±0．3）×10-8 mol/L vs．（1．7±0．3）×10-8 mol/L]（P ＜0．05），이량조 aβ2 GPI-IgA 적농도무명현차이。결론무론유무 SLE 기출면역성질병，IgG 류 aβ2 GPI 여정맥혈전형성유명현적관련성，IgM류 aβ2 GPI 여동맥혈전형성상관。
Objective To investigate the role of different classes of anti-β2-glycoprotein I antibodies in patients with systemic lupus erythematosus(SLE)complicated with thrombosis.Methods According to the patients who suffered with clinical thrombotic events or not,SLE patients were divided into the SLE-non-APS group and SLE-APS group.While patients with primary antiphospholipid antibody syndrome were included in the PAPS group.All these patients were positive for anti-β2-glycoprotein I antibodies,and traditional risk factors for thrombosis were excluded.Levels of anti-β2 GPI IgA,anti-β2 GPI IgG,anti-β2 GPI IgM,were detected by ELISA assays.In addition,patients in SLE-APS group and PAPS group were separated into two groups:patients suffered with arterial thromboembolic events were included in the APS-A group,patients suffered with venous thromboembolic events were included in APS-V group.The above parameters between the two groups were compared.Results In Total 82 patients were enrolled including 64 cases with SLE and 18 primary antiphospholipid antibody syndrome(PAPS group).Of the 64 cases with SLE,52 were furthered included in the SLE-non-APS group and 12 in the SLE-APS group.In total 30 patients were in the SLE-APS group and the PAPS group were composed of 23 cases in the APS-A group and 7 cases in the APS-V group. The anti-β2 GPI IgA [(1.3 ±0.4)×10 -8 mol/L]and anti-β2 GPI IgM [(1.0 ±0.2)×10 -8 mol/L]were with low density in SLE-APS group than that in the SLE-non-APS group [aβ2 GPI-IgA:(1.8 ±0.9)× 10 -8 mol/L,aβ2 GPI-IgM:(1.5 ±0.7 )×10 -8 mol/L] (P <0.05 ),but there was no significant difference in the concentration of anti-β2 GPI IgG between the SLE-APS group and the SLE-non-APS group. There was no significant difference in the concentration of anti-β2 GPI IgA,anti-β2 GPI IgG,anti-β2 GPI IgM between the SLE-APS group and PAPS group.The APS-A group had a higher concentration of anti-β2 GPI IgM [(1.2 ±0.5)×10 -8 mol/L]than the APS-V group [(0.7 ±0.1)×10 -8 mol/L](P <0.05),but a lower concentration of anti-β2 GPI IgG [(1.4 ±0.3)×10 -8 mol/L vs.(1.7 ±0.3)×10 -8 mol/L](P <0.05),but there was no significant difference between the two groups in the concentration of anti-β2 GPI IgA.Conclusion No matter patients are with SLE or not,there is nosigwifieant correlation between anti-β2 GPI IgG and venous thrombosis,but the anti-β2 GPI IgM antibody is significantly correlated with arterial thrombosis.