Clinical significance of anti-cardiolipin antibodies in patients with lupus nephritis / 中国组织工程研究

ABSTRACT

BACKGROUND:Previous studies have documented that,the increase of anti-cardiolipin(aCL) antibody titer has an obvious positive relaltionship with the vascular thrombosis,thrombocytopenia and repeated abortion in the patients with systemic lupus erythematosus and antiphospholipid syndrome,but there is little information on the aCL antibodies in lupus nephritis(LN).OBJECTIVE:To ascertain the preyalence and significance of aCL antibodies in Chinese patients with LN.DESIGN:Prospective follow-up study of one sample.SETTING:Department of Rheumatology in Xiangmihu Branch of Shenzhen Fourth People's Hospital,Shenzhen Institute of Rheumatology in Guangdong Medical College.PARTlCIPANTSThe study was performed in 97 LN Patients consecutively recruited in the Department of Rheumatology in Xiangmihu Branch of Shenzhen Fourth People's Hospital between March 2001 and October 2003.All the included patients met the revised criteria of American College of Rheumatology for the diagnosis and classification of LN.And they all knew the fact saying yes.METHODS:The clinical data and auxiliary examination result were recorded when hospitalizalion.The aCL antibodies were measured by the enzyme-linked immunosorbent assay,and Were considered as positive if over 100 U/mL.High-dose oral administration of prednisonc combined with cyclophosphamide intravenous pulse therapy were applied for inducing release.The curative effect was remained by using azathioprine and prednisone at a decreasing dose.Meanwhile the complications such as hypertension,hyperlipemia and arthralgia were prevented by drugs.All the patients had routine visits at six-month intervals for a total of 3 years,Clinical and seroIogic manifestations of Patients with LN were tested and recorded regularly.MAIN OUTCOME MEASURES:Gender,age,systemic lupus erythematosus disease activity index,clinical manifestations,vascular thrombosis,pregnancy outcome and renal function.RESULTS:All the 97 LN Patients were included in the study.and 83 of them entered the result analysis while the other 14 cases were lost.The overall prevalence of aCL antibodies in 97 subjects was 39%(38 cases).Hypertension,thrombocytopenia and Raynaud's phenomenon were more frequent in LN Patients with aCL antibodies.The aCL IgG antibody-positive Patients showed a greater risk for the occurrence of vascular thrombosis;Pregnancy morbidity of miscarriages,premature birth,fetal death and the probabmty of developing irreversible renal function deterioration occurred at a greater frequency in aCL antibody-positive patients.CoNCLUSIoN:The prevalence of aCL antibodies in LN Patients is 39%.A higher incidence of hypertension.thrombocytopenia and Raynaud's phenomenon is found in patients with aCL antibodies.Detection of aCL antibodies in Patients with LN may be usefol to predict the development of vascular thrombosis,pregnancy morbidity and irreversible chronic renal function deterioration.