测定抗心磷脂抗体抗心肌线粒体抗体在诊治扩张型心肌病中意义.docVIP

测定抗心磷脂抗体抗心肌线粒体抗体在诊治扩张型心肌病中意义 　　【摘要】目的比较抗心磷脂抗体（ACA）和抗心肌线粒体抗体（ACMA）对扩张型心肌病（DCM）诊断及治疗评估价值。方法采用ELISA法测定DCM，30例患儿ACA-lgG和ACMA-lgG，并与健康者对照，同时检测心肌酶、心电图和多普勒超声心动图。结果DCM患儿ACA-lgG和ACMA-lgG阳性率分别为53.3%和40.0%，均显著高于健康者（P 0.05）。结论ACA-lgG阳性对DCM患者诊断和病情轻重判定均有重要意义；ACMA-lgG阳性虽对DCM患儿诊断有一定价值，但对病情判断无作用。 　　【关键词】扩张型心肌病；抗心磷脂抗体；抗心肌线粒体抗体 　　 　　Significance of comparison betweenanticard iolipinantibody andanticardiacmi to chondrialanti bodyindi latedcardiomyopathy Dang Jian-yinthe total Hospital Of Jianghan Oil Field In Hubei Province. Qianjiang433124，China. 　　【Abstract】ObjectiveTo compare the action of anticardionlipin antibody(AC-A) and anticardiac mitochondrial antibody (ACMA) in therapy and treatment of children with dilated cardiomyopathy(DCM). MehtodsELISA was used to measure ACA-lgG and ACMA-lgG in 30 children with DCM and 40 healthy children as comtrols. CK-MB,electrocardiogram and Doppler echocardiography were examined simultaneously.Results The positive rate of ACA-lgG in DCM children was 53.3% and 40.4% respectively, both significantly higher than those of healthy children. The CH-MB level , the rate of arrhythmia,the enlargement rates of cardiacchambers and the decrease rate of systolic function of left ventricle(VL) were significantly higher in DCM children with ACA-lgG positive than those with ACA-lgG negative, but no significant difference betweeh ACMA-lgG positive and negative children.ConclusionThe study showed that positive ACA played an important role in diagnosis of DCM, but helpless for judging the severity of DCM. 　　【Key words】 dilated cardiomyopathy; anticardiolipin; antibody; anticardiac mitochondrial antibody; 　　 　　自身免疫是扩张型心肌病（DCM）的主要发病机制之一，自身免疫与DCM有关的证据是患儿体内存在自身免疫抗体，这些抗体是持续心肌损害的标记[1]。我们检测了DCM患儿血清抗心磷脂抗体（ACA）和抗心肌线粒体抗体（ACMA），并对二者的作用进行了比较。 　　 　　1 病例与方法 　　 　　1.1病例2002年12月至2007年2月我院儿科和内科就诊的DCM患者30例，其中男21例，女9例，年龄1～14岁，平均8岁；同期无感染史及激素应用史、经查体及辅助检查证实健康儿童40名为正常对照组，男女各20名，年龄1～14岁，平均8岁。 　　1.2方法抗心磷脂抗体lgG（ACA-lgG）测定：采用ELISA法，试剂盒由上海第二医科大ip 科技中心实验室提供。实验结果以结合指数（BI）表示，正常值建立以健康