严重急性呼吸系统综合征后骨坏死与抗心磷脂抗体

时间:2020-10-08 17:34:15 药学毕业论文 我要投稿

严重急性呼吸系统综合征后骨坏死与抗心磷脂抗体

作者:孙伟,李子荣,史振才,林朋
【关键词】 抗心磷脂抗体
摘 要:[目的]测定严重急性呼吸系统综合征(severe acute respiratory syndrome,SARS)后骨坏死患者的抗心磷脂抗体,探讨SARS后骨坏死的病因学,以便用于非创伤性骨坏死的早期诊断和易感人群的筛选。[方法]取62例SARS后骨坏死患者抽取空腹肘静脉血,另取健康人群52名为对照,应用酶联免疫吸附法测定抗心磷脂抗体的IgA、IgG和ISM,并检测血浆凝血酶原时间(PT)和凝血酶时间(TT),凝血酶原活动度(PTA)和国际标准化值(INR)4项常规出凝血检查。[结果]SARS后骨坏死患者抗心磷脂抗体阳性者多见。骨坏死组62人中有21人出现抗心磷脂抗体阳性,占339%,其中IgA(1133±11209)APL,IgG(5127±5927)GPL,IgM(17821±10606)MPL。对照组52人中仅有4人出现异常,占77%,其中IgA(10702±3126)APL,IgG(5184±4780)GPL,IgM(14684±5516)MPL,经独立样本t检验和卡方检验处理,两组之间有显著性差异(P<005)。血浆凝血酶原时间(PT)和凝血酶时间(TT),凝血酶原活动度(PTA)和国际标准化值(INR)4项常规出凝血检查两组之间无显著性差异。[结论]SARS后骨坏死患者的抗心磷脂抗体阳性率增多,抗心磷脂抗体可能在骨坏死发生中起作用。
关键词:骨坏死; SARS; 抗心磷脂抗
Abstract:[Objective]To explore the correlation between anticardiolipin antibodies and postSARS patients with osteonecrosis,investigate the etiology of postSARS osteonecrosis,and select the sensitive molecular symbols for early diagnosis and distinguish the high risk population[Method]The studied subjects were divided into two groupsSixtytwo postSARS patients with osteonecrosis was one group,and 52 matched healthy people was as normal controlled groupEmpty stomach blood samples from cubital veins were collected from both groupsIgA,IgG and IgM of anticardiolipin antibodies types were examined by ELISA[Result]Twentyone of 62 postSARS osteonecrosis patients were tested at least one type of anticardiolipin antibodies positive,among them,with IgA(1133±11209)APL,IgG(5127±5927)GPL,IGM(17821±10606)MPLFour of 52 control group persons were detected positive,with IGA(10702±3126)APL,IgG(5184±4780)GPL,IgM(14684±5516)MPLThere were significant differences between two groups,while,there were no difference in prothrombin time(PT),thrombin time(TT),prothrombin activity(PTA)and international normalized ratio(INR)[Conclusion]The study indicates an increased positive incidence of anticardiolipin antibodies in postSARS patients with osteonecrosisThis has reflected that anticardiolipin antibodies may play a role in osteonecrosis
Key words:Osteonecrosis; SARS; Anticardiolipin antibodies
非创伤骨坏死的病因和发病机理尚不十分清楚,目前认为血管内凝血使骨内血管阻塞,导致骨循环的中断和骨细胞的`缺血是骨坏死的共同通路。有文献报道骨坏死的发生与患者的高凝低纤溶状态有关〔1〕,而抗心磷脂抗体是与血栓形成密切相关的异质性自身抗体,作者对SARS后骨坏死患者的血清抗心磷脂抗体进行检测,探讨抗心磷脂抗体与骨坏死发生是否具有相关性。
1 材料与方法
在2003年春的严重急性呼吸系统综合征(severe acute respiratory syndrome,SARS)感染患者中,作者于2003年12月~2004年2月进行全身多关节(双髋、双膝、双踝、双肩、部分患者加双腕)MRI影像学普查,研究对象为62例发生骨坏死患者,其中男性25例,女性37例;平均302岁(20~60岁)。激素(折合成甲强龙)使用量平均6 2508 mg(1 500~25 600mg),每日最大剂量平均3445 mg(80~860 mg),使用时间平均421 d(16~102 d),其中股骨干坏死1例,单纯股骨头坏死16例(单侧4例,双侧12例),单纯膝关节坏死7例(单侧3例,双侧4例),多关节坏死38例,对照组取正常健康人群52例,男性22例,女性33例,平均351岁(15~61岁)。