The evaluation of clinical value of antiphospholipid syndrome related autoantibodies / 中华检验医学杂志

ABSTRACT

Objective To evaluate the clinical application value of anti-β2 glycoprotein I ( anti-β2 GPI) and anti-cardiolipin antibodies ( ACA ) in the patients with antiphospholipid syndrome ( APS).Methods Serum levels of anti-β2GPI(IgG) and ACA(IgA, IgG, IgM) were determined by enzyme linked immunosorbent assay ( ELISA ) in 53 patients with APS , 27 patients with SLE accompanied by APS , 55 patients with simple SLE , 46 patients with other autoimmune diseases and 40 healthy controls.The sensitivity and specificity of anti-β2 GPI and ACA for the diagnosis of APS and the correlation of serum anti-β2 GPI and ACA-IgG levels were analyzed.The cases were identified in the Affiliated Hospital of Qingdao University during 2012.1 to 2014.2 and the data were analyzed with χ2 test, Mann-Whitney U test and Spearman correlation.Results The positive rates and serum levels of anti-β2 GPI, ACA-IgG/M, ACA-IgG, ACA-IgM were significantly higher in the APS group [77.4%(41/53), 81.1%(43/53), 56.6%(30/53), 52.8%(28/53);14.1 AU/ml, 19.6 U/ml, 17.9 U/ml] than those in the simple SLE group [16.4%(9/55), 32.7%(18/55), 20.0%(11/55), 18.2%(10/55); 4.9 AU/ml, 9.4 U/ml, 8.7 U/ml, χ2 =40.4, 25.7, 15.4, 14.2;U=255.0, 632.5, 476.5, P<0.01], other autoimmune diseases group[0%(0/46), 4.3%(2/46), 2.2%(1/46), 2.2%(1/46); 3.2 AU/ml, 2.6 U/ml, 3.4 U/ml, χ2 =60.7, 58.6, 33.9, 30.5;U=53.5, 87.0, 66.0, P<0.01] and healthy controls [0%(0/40), 2.5%(1/40), 0%(0/40), 2.5%(1/40);3.0 AU/ml, 3.5 U/ml, 2.9 U/ml, χ2 =55.3, 56.5, 33.4, 26.9;U=61.0, 124.0, 152.0, P <0.01 ] separately.The positive rate and serum level of ACA-IgA in the APS group [18.9%(10/53), 11.7 U/ml] were significantly higher than that in the other autoimmune disease group [2.2%(1/46), 2.9 U/ml,χ2 =6.9, U=581.0, P<0.01] and healthy controls[2.5%(1/40),2.1 U/ml,χ2 =4.4,U=764.0,P<0.05] separately.The specificity of anti-β2 GPI (83.6%) for APS diagnosis was significantly higher than that of ACA (67.3%, χ2 =4.0,P<0.05).Conclusions anti-β2 GPI, ACA-IgG and ACA-IgM, have higher clinical application value in the APS diagnosis and identification of SLE with or without APS than ACA-IgA.The specificity of anti-β2 GPI for APS diagnosis is higher than that of ACA.