抗心磷脂抗体及抗β2糖蛋白1抗体检测血脂正常脑梗死患者的临床意义
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摘要
目的研究抗心磷脂抗体(ACA)及抗β2糖蛋白1抗体(anti-β2-GP1)在脑梗死患者中的表达及其临床意义。方法选取确诊的脑梗死患者211例,按照是否合并高脂血症,分为血脂正常脑梗死组(n=121)和高脂血症合并脑梗死组(n=90)。采用酶联免疫吸附测定(ELISA)对两组患者血清IgA、IgG、IgM型ACA和anti-β2-GP1进行测定并比较两组阳性率的差异;同时比较不同年龄、性别、病灶数量的血脂正常脑梗死组患者ACA和anti-β2-GP1阳性率差异及脑梗死患者两类抗体之间的相关性。结果血脂正常脑梗死组和高脂血症合并脑梗死组的ACA阳性率分别为14.0%和4.4%(χ~2=4.295,P=0.038),anti-β2-GP1阳性率分别为17.4%和5.6%(χ~2=6.651,P=0.010)。血脂正常脑梗死组患者中,90例单发性脑梗死和31例多发性脑梗死患者的ACA阳性率分别为8.9%和29.0%(χ~2=7.748,P=0.005),anti-β2-GP1阳性率分别为10.0%和38.7%(χ~2=13.250,P=0.000);在血脂正常脑梗死组患者中,≤50岁67例,>50岁54例,ACA阳性率分别为20.9%和5.6%(χ~2=4.626,P=0.031),anti-β2-GP1阳性率分别为25.4%和7.4%(χ~2=5.534,P=0.019);ACA和anti-β2-GP1阳性率在性别上差异无统计学意义(P>0.05);一致性χ~2检验显示211例脑梗死患者ACA和anti-β2-GP1有相关性(P<0.05)。结论 ACA及anti-β2-GP1可能是血脂正常中青年脑梗死患者的重要发病原因之一,临床应加强对这类人群ACA及anti-β2-GP1的联合检测。
Objective To study the expression and clinical significance of anti cardiolipin antibody(ACA)and anti beta 2 glycoprotein 1 antibody(anti-β2-GP1)in cerebral infarction without hyperlipidemia group.Methods A total of 211 patients with cerebral infarction were selected and divided into two groups according to whether they were hyperlipidemia:cerebral infarction without hyperlipidemia group and hyperlipidemia combined cerebral infarction group.The serum levels of IgA,IgG,IgM type ACA and anti-β2-GP1 were measured by enzyme linked immunosorbent assay(ELISA),the positive rates of the two groups were compared.The positive rates of ACA and anti-β2-GP1 in patients with cerebral infarction with different ages,genders and number of lesions were compared,the correlation between the two types of antibodies in patients with cerebral infarction were analyzed.Results There were 121 cases of cerebral infarction without hyperlipidemia group,90 cases of cerebral infarction with hyperlipidemia group.The positive rates of ACA were 14.0% and 4.4%(χ~2=4.295,P=0.038),respectively.The positive rates of anti-β2-GP1 were 17.4% and 5.6%(χ~2=6.651,P=0.010),respectively.The positive rates of ACA and anti-β2-GP1 in the two groups were statistically difference.Among the patients of cerebral infarction without hyperlipidemia group,90 cases were single cerebral infarction and 31 cases were multiple cerebral infarction.The positive rates of ACA were 8.9% and29.0%(χ~2=7.748,P=0.005),respectively.The positive rates of anti-β2-GP1 were 10.0% and 38.7%(χ~2=13.250,P=0.000),respectively.In the patients in cerebral infarction without hyperlipidemia group,67 cases were less than 50 years old,54 cases were more than 50 years old.The positive rates of ACA were 20.9%and5.6%(χ~2=4.626,P=0.031),respectively.The positive rates of anti-β2-GP1 were 25.4% and 7.4%(χ~2=5.534,P=0.019),respectively.ACA and anti-β2-GP1 in the two groups were statistically difference,but no statistically difference in sex(P>0.05).Conformance chi-square tests showed a correlation between ACA and anti-β2-GP1 in 211 patients with cerebral infarction(P<0.05).Conclusion ACA and anti-β2-GP1 may be one of the important etiological factors of cerebral infarction without hyperlipidemia in middle-aged patients.It is important to pay more attention to the combined detection of ACA and anti-β2-GP1 in this group of people.
Objective To study the expression and clinical significance of anti cardiolipin antibody(ACA)and anti beta 2 glycoprotein 1 antibody(anti-β2-GP1)in cerebral infarction without hyperlipidemia group.Methods A total of 211 patients with cerebral infarction were selected and divided into two groups according to whether they were hyperlipidemia:cerebral infarction without hyperlipidemia group and hyperlipidemia combined cerebral infarction group.The serum levels of IgA,IgG,IgM type ACA and anti-β2-GP1 were measured by enzyme linked immunosorbent assay(ELISA),the positive rates of the two groups were compared.The positive rates of ACA and anti-β2-GP1 in patients with cerebral infarction with different ages,genders and number of lesions were compared,the correlation between the two types of antibodies in patients with cerebral infarction were analyzed.Results There were 121 cases of cerebral infarction without hyperlipidemia group,90 cases of cerebral infarction with hyperlipidemia group.The positive rates of ACA were 14.0% and 4.4%(χ~2=4.295,P=0.038),respectively.The positive rates of anti-β2-GP1 were 17.4% and 5.6%(χ~2=6.651,P=0.010),respectively.The positive rates of ACA and anti-β2-GP1 in the two groups were statistically difference.Among the patients of cerebral infarction without hyperlipidemia group,90 cases were single cerebral infarction and 31 cases were multiple cerebral infarction.The positive rates of ACA were 8.9% and29.0%(χ~2=7.748,P=0.005),respectively.The positive rates of anti-β2-GP1 were 10.0% and 38.7%(χ~2=13.250,P=0.000),respectively.In the patients in cerebral infarction without hyperlipidemia group,67 cases were less than 50 years old,54 cases were more than 50 years old.The positive rates of ACA were 20.9%and5.6%(χ~2=4.626,P=0.031),respectively.The positive rates of anti-β2-GP1 were 25.4% and 7.4%(χ~2=5.534,P=0.019),respectively.ACA and anti-β2-GP1 in the two groups were statistically difference,but no statistically difference in sex(P>0.05).Conformance chi-square tests showed a correlation between ACA and anti-β2-GP1 in 211 patients with cerebral infarction(P<0.05).Conclusion ACA and anti-β2-GP1 may be one of the important etiological factors of cerebral infarction without hyperlipidemia in middle-aged patients.It is important to pay more attention to the combined detection of ACA and anti-β2-GP1 in this group of people.
引文
[1]杜真真,张灿飞,汤媛媛,等.大动脉粥样硬化性脑梗死不同发病机制的危险因素分析[J].中华老年心脑血管病杂志,2016,18(4):394-397.
[2]ERKAN D,BARBHAIYA M,GEORGE D,et al.Moderate versus high-titer persistently anticardiolipin antibody positive patients:are they clinically different and does high-titer anti-beta 2-glycoprotein-I antibody positivity offer additional predictive information?[J].Lupus,2010,19(5):613-619.
[3]IWANIEC T,KACZOR M P,CELISKA-LWENHOFFM,et al.Clinical significance of anti-domain 1β2-glycoproteinⅠantibodies in antiphospholipid syndrome[J].Thromb Res,2017(153):90-94.
[4]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[5]ARVANITAKIS Z,BREY R L,RAND J H,et al.Relation of antiphospholipid antibodies to postmortem brain infarcts in older persons[J].Circulation,2014,131(2):182-189.
[6]孙继红,张艳,张洵岳,等.脑梗死患者与血清抗心磷脂抗体及β2糖蛋白Ⅰ抗体的关系研究[J].检验医学与临床,2016,13(8):1100-1101.
[7]URBANUS R T,DE GROOT P G.Antiphospholipid antibodies-we are not quite there yet[J].Blood Rev,2011(25):97-106.
[8]TORTOSA C,CABRERA-MARANTE O,SERRANO MA,et al.Incidence of thromboembolic events in asymptomatic carriers of IgA anti beta 2glycoprotein-I antibodies[J].PLoS One,2017,12(7):e0178889.
[9]郑加永,周武,张雪良,等.脑卒中患者抗心磷脂抗体的检测及分析[J].中国临床神经科学,2005,13(3):298-299.
[10]张蜀澜,李永哲.抗磷脂抗体检测的现状及展望[J].中华检验医学杂志,2014,37(8):564-566.
[11]UEDA N,SATOH S,KUROIWA Y.Multiple cerebral infarction and cardiomyopathy with pheochromocytoma[J].Neurologist,2011,17(1):34-37.
[12]MAEKAWA K,SHIBATA M,SEGUCHI M,et al.Multiple cerebral infarctions due to patent foramen ovale in a patient with eosinophilic granulomatosis with polyangiitis[J].J Stroke Cerebrovasc Dis,2018,27(6):e92-e94.
[13]CHATURVEDI S,COCKRELL E,ESPINOLA R,et al.Circulating microparticles in patients with antiphospholipid antibodies:characterization and associations[J].Thromb Res,2015,135(1):102-108.
[14]GOLDUST M,TALEBI M,MAJIDI J,et al.Evaluation of antiphospholipid antibodies in youths suffering from cerebral ischemia[J].Int J Neurosci,2013,123(3):209-212.
[15]冯敏,张友好,许媛媛,等.急性脑梗死患者血清抗心磷脂抗体检测的临床意义[J].中华全科医学,2013,11(12):1863-1864.
[16]张英丽,赵晴,李新颖,等.缺血性脑血管病患者血清抗心磷脂抗体水平及其临床意义[J].中国老年学杂志,2011,31(15):2860-2861.
[17]张义东,王青青,张叶锋,等.原发性干燥综合征患者血清抗心磷脂抗体与抗β2糖蛋白1抗体的表达及意义[J].中华医院感染学杂志,2016,26(9):2033-2035.
[18]黄媛,崔巍.抗磷脂综合征血栓形成机制的研究进展[J].中华医学杂志,2016,96(39):3186-3189.
[2]ERKAN D,BARBHAIYA M,GEORGE D,et al.Moderate versus high-titer persistently anticardiolipin antibody positive patients:are they clinically different and does high-titer anti-beta 2-glycoprotein-I antibody positivity offer additional predictive information?[J].Lupus,2010,19(5):613-619.
[3]IWANIEC T,KACZOR M P,CELISKA-LWENHOFFM,et al.Clinical significance of anti-domain 1β2-glycoproteinⅠantibodies in antiphospholipid syndrome[J].Thromb Res,2017(153):90-94.
[4]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[5]ARVANITAKIS Z,BREY R L,RAND J H,et al.Relation of antiphospholipid antibodies to postmortem brain infarcts in older persons[J].Circulation,2014,131(2):182-189.
[6]孙继红,张艳,张洵岳,等.脑梗死患者与血清抗心磷脂抗体及β2糖蛋白Ⅰ抗体的关系研究[J].检验医学与临床,2016,13(8):1100-1101.
[7]URBANUS R T,DE GROOT P G.Antiphospholipid antibodies-we are not quite there yet[J].Blood Rev,2011(25):97-106.
[8]TORTOSA C,CABRERA-MARANTE O,SERRANO MA,et al.Incidence of thromboembolic events in asymptomatic carriers of IgA anti beta 2glycoprotein-I antibodies[J].PLoS One,2017,12(7):e0178889.
[9]郑加永,周武,张雪良,等.脑卒中患者抗心磷脂抗体的检测及分析[J].中国临床神经科学,2005,13(3):298-299.
[10]张蜀澜,李永哲.抗磷脂抗体检测的现状及展望[J].中华检验医学杂志,2014,37(8):564-566.
[11]UEDA N,SATOH S,KUROIWA Y.Multiple cerebral infarction and cardiomyopathy with pheochromocytoma[J].Neurologist,2011,17(1):34-37.
[12]MAEKAWA K,SHIBATA M,SEGUCHI M,et al.Multiple cerebral infarctions due to patent foramen ovale in a patient with eosinophilic granulomatosis with polyangiitis[J].J Stroke Cerebrovasc Dis,2018,27(6):e92-e94.
[13]CHATURVEDI S,COCKRELL E,ESPINOLA R,et al.Circulating microparticles in patients with antiphospholipid antibodies:characterization and associations[J].Thromb Res,2015,135(1):102-108.
[14]GOLDUST M,TALEBI M,MAJIDI J,et al.Evaluation of antiphospholipid antibodies in youths suffering from cerebral ischemia[J].Int J Neurosci,2013,123(3):209-212.
[15]冯敏,张友好,许媛媛,等.急性脑梗死患者血清抗心磷脂抗体检测的临床意义[J].中华全科医学,2013,11(12):1863-1864.
[16]张英丽,赵晴,李新颖,等.缺血性脑血管病患者血清抗心磷脂抗体水平及其临床意义[J].中国老年学杂志,2011,31(15):2860-2861.
[17]张义东,王青青,张叶锋,等.原发性干燥综合征患者血清抗心磷脂抗体与抗β2糖蛋白1抗体的表达及意义[J].中华医院感染学杂志,2016,26(9):2033-2035.
[18]黄媛,崔巍.抗磷脂综合征血栓形成机制的研究进展[J].中华医学杂志,2016,96(39):3186-3189.