ISSN 1006-298X      CN 32-1425/R

导航

肾脏病与透析肾移植杂志 ›› 2021, Vol. 30 ›› Issue (5): 414-419.DOI: 10.3969/j.jssn.1006-298X2021.5.003

• • 上一篇    下一篇

抗磷脂酰丝氨酸/凝血酶原复合物抗体与标准抗磷脂抗体在狼疮性肾炎中的应用

  

  • 出版日期:2021-10-28 发布日期:2021-10-28

Application of antiphosphatidylserine/prothrombin antibodies and criteria antiphospholipid antibodies in lupus nephritis

  • Online:2021-10-28 Published:2021-10-28

摘要: 目的:探讨抗磷脂酰丝氨酸/凝血酶原复合物抗体(aPS/PT)与“标准”抗磷脂抗体(aPL)在狼疮性肾炎中的应用。
方法:选取2020年12月至2021年4月在国家肾脏疾病临床医学研究中心就诊的82例LN患者,检测“标准”aPL狼疮抗凝物(LA)、抗心磷脂抗体(aCL)、抗β2糖蛋白1抗体(aβ2GP1)和“非标准”aPL aPS/PT。根据“标准”aPL检测结果,将患者分为“标准”阳性组和“标准”阴性组;再根据aPS/PT检测结果分为“标准和(或)aPS/PT”阳性组和“标准和aPS/PT”阴性组,比较各组的临床、实验室资料以及肾组织病理。
结果:LA、aCL和aβ2GP1检出率分别为220%、134%和390%;aPS/PT检出率为488%,其中aPS/PT IgG检出率为256%,aPS/PT IgM检出率为354%。LA阳性患者中,aPS/PT IgG/IgM阳性率高达944%。aPS/PT IgG与LA一致性最强,Cohen’s kappa系数0429(P<001)。aPS/PT IgG阳性与血栓形成风险和神经精神狼疮发生呈正相关。“标准和(或)aPS/PT”阳性组C3、C4显著低于“标准和aPS/PT”阴性组(P<005),SLE疾病活动性指数显著高于“标准和aPS/PT”阴性组(P<005)。
结论:aPS/PT与LA具有较好的一致性,补充检测aPS/PT有助于识别LN患者中血栓事件、神经精神狼疮、狼疮活动等风险。


Abstract: Objective:To study the application of antiphosphatidylserine/prothrombin antibodies (aPS/PT) and “standard” antiphospholipid antibodies(aPL) in lupus nephritis(LN).
Methodology:82 LN patients treated in Jinling Hospital from December 2020 to April 2021 were selected to detect lupus anticoagulant (LA), anticardiolipin antibodies (aCL), antiβ2glycoprotein1 antibodies (aβ2GP1) and aPS/PT.According to the criteria aPL results, the patients were divided into “standard” positive group and “standard” negative group,and than divided into “standard” and/or aPS/PT positive group and “standard” and aPS/PT negative group according to the results of aPS/PT.The clinical and laboratory data and renal histopathology of each group were compared.
Results:The positive rates of LA, aCL and aβ2GP1 in 82 LN patients were 220%, 134% and 390%, respectively.A total of 40 (488%) LN patients were positive in IgG/IgM aPS/PT, including 256% patients positive in aPS/PT IgG and 354% positive in aPS/PT IgM.Among the LA positive patients, 944% of the patients were IgG/IgM aPS/PT positive.The consistency between aPS/PT IgG and LA was the strongest, and the Cohens kappa coefficient was 0429 (P<001).IgG aPS/PT positive was positively correlated with the risk of thrombosis and neuropsychiatric lupus.The levels of C3 and C4 in the “standard” and/or aPS/PT positive group were significantly lower than those in the negative group, while the level of SLEDAI in the “standard” and/or aPS/PT positive group was significantly higher than that in the “standard” and aPS/PT negative group.
Conclusion:There is a good correlation and consistency between aPS/PT and LA.Additional detection of aPS/PT is helpful to identify the risk of thrombotic events, neuropsychiatric lupus and lupus activity in patients with LN.