COAGULATION SCREEN IS MORE SPECIFIC THAN THE ANTICARDIOLIPIN ANTIBODY ELISA IN DEFINING A THROMBOTIC SUBSET OF LUPUS PATIENTS
COAGULATION SCREEN IS MORE SPECIFIC THAN THE ANTICARDIOLIPIN ANTIBODY ELISA IN DEFINING A THROMBOTIC SUBSET OF LUPUS PATIENTS
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DOI：
10.1136/ard.47.5.364
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发表时间：
1988-05-01
影响因子：
27.4
通讯作者：
DEGROOT, PG
中科院分区：
文献类型：
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作者：
DERKSEN, RHWM;HASSELAAR, P;DEGROOT, PG
在 111 名狼疮患者中，我们比较了 IgG 和 IgM 抗心磷脂抗体 (ACA) 酶联免疫吸附测定 (ELISA) 和四种不同的狼疮抗凝 (LAC) 测定（患者和对照血浆与动物 (PTT-st) 或人脑 (PTT-HB) 磷脂 1:1 混合物的部分凝血活酶时间 (PTT)；PTT 与人脑稀释液磷脂（PL 稀释）；以及患者和对照血浆混合物的高岭土凝固时间 (KCT)），以识别患有血栓形成 (26/111)、胎儿流产 (19/46) 和/或血小板减少症 (11/106) 的患者。 PTT-HB 和 PL 稀释液对血栓形成的特异性最高 (87%)（灵敏度 65%，检出率 61%）；对于胎儿丢失（93％），使用PL稀释（敏感性47％；检出率82％），以及对于血小板减少症（83％）使用KCT（敏感性82％；检出率36％）。与LAC检测相比，ACA-ELISA的灵敏度较高（≥77%），但特异性（≤51%）和检出率（≤52%）较低。因此，一组三种 LAC 检测（PTT-HB、PL 稀释和 KCT）可以识别明显处于血栓形成、胎儿流产和/或血小板减少症风险的狼疮患者，而 ACA-ELISA 的特异性不够。
In 111 lupus patients we compared the potential of the IgG and IgM anticardiolipin antibody (ACA) enzyme linked immunosorbent assay (ELISA) and four different lupus anticoagulant (LAC) assays (partial thromoboplastin time (PTT) of a 1:1 mixture of patient and control plasma with phospholipids from animal (PTT-st) or human brain (PTT-HB); PTT with dilutions of human brain phospholipids (PL dilution); and kaolin clotting time of mixtures of patient and control plasma (KCT)) to identify patients with thrombosis (26/111), fetal loss (19/46), and/or thrombocytopenia (11/106). The highest specificity for thrombosis (87%) was found with PTT-HB and PL dilution (sensitivity 65%, detection rate 61%); for fetal loss (93%) with PL dilution (sensitivity 47%; detection rate 82%), and for thrombocytopenia (83%) with KCT (sensitivity 82%; detection rate 36%). Compared with LAC assays, the sensitivity of ACA-ELISA was high (.gtoreq. 77%), but specificity (.ltoreq. 51%) and detection rate (.ltoreq. 52%) were low. So, a panel of three LAC assays (PTT-HB, PL dilution, and KCT) can identify lupus patients apparently at risk for thrombosis, fetal loss and/or thrombocytopenia, whereas the ACA-ELISA is insufficiently specific.