论文部分内容阅读
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 anti-activated protein C (APCR) in patients with systemic lupus erythematosus (SLE) and its clinical significance. Methods APCR was measured as APC SR, a sensitive ratio of activated partial thromboplastin time (APTT) activated by activated plasma protein C (APC) to APTT without APC, and was APCR positive when APC SR <20. Results The positive rate of APCR in SLE patients was 57.4%, which was significantly higher than that in the control group (χ2 = 16 332, P <0 055). There was a difference in the incidence of thrombosis and recurrent miscarriage between APCR positive patients and negative patients There was a significant correlation between APCR and lupus anticoagulant (LA) (χ2 = 4 2 41, P 0 05). There was no correlation between APCR and other clinical features and the positive rate of autoantibodies. Conclusions APCR is closely related to LA, and antiphospholipid antibody (APL) inhibits protein C system. APCR may be one of the risk factors for thrombosis in patients with SLE. The detection of APL antibody and APCR may have predictive value for thrombosis in patients with SLE.