摘要 目的 探讨抗心磷脂抗体(ACA)与青光眼疾患的临床相关意义。方法 对26例青光眼患者及11例非青光眼患者，采用抗心磷脂抗体酶免疫(ELISA)测定法，进行抗心磷脂抗体检测。结果 青光眼组IgG ACA与IgM ACA值均比对照组高，有显著差异(P＜0.05)；其中开角型青光眼IgG ACA与对照组之IgG ACA值比较无显著差异(P＞0.05)；开角型青光眼IgM ACA与对照组之IgM ACA值比较有显著差异(P＜0.05)。闭角型青光眼与对照组比较：IgG ACA与IgM之ACA值比较均有显著差异(P＜0.05)。结论 青光眼病人的抗心磷脂抗体较高，预测可能产生视网膜静脉阻塞，需进一步追踪随访。
Application of anticardiolipin antibodies test in glaucoma
ZHUANG Xiao-Pig,ZHOU Yan-Ying
Abstract Objective To investigate whether anticardiolipin antibodies(ACA) correlates with glaucoma clinically.Methods ELISA was used to measure ACA of 26 glaucoma patients and 11 non-glaucoma patients. Results Both scores of the IgG ACA and IgM ACA of the glaucoma group were higher than those of the control group(P＜0.05),and there was a significant difference between the two groups.There was no difference between the IgM ACA of the open-angle glaucoma group and that of the control group(P＞0.05),but the IgG ACA of the closed-angle glaucoma group was different from that of the control group (P＜0.05).Conclusions The high score of ACA may result in retinal vein occlusion.Though the view needs to be further tested,people still should pay attention to ACA of glaucoma and make efforts to change it into negative to prevent retinal vein occlusion.
Key words glaucoma;anticardiolipin antibody;retinal vein occlusion
［Rec Adv Ophthalmol 1999;19(3)∶184-186］ 抗心磷脂抗体(ACA)的存在与血栓形成、血管栓塞以及血小板减少等具有显著相关的意义［1～3］。鉴于青光眼有高凝状态［4］和有视网膜静脉栓塞造成视功能损害之情况。作者为探讨抗心磷脂抗体与青光眼疾患的临床相关意义，对青光眼患者及非青光眼患者进行了抗心磷脂抗体检测与比较，现报告如下。
1 对象和方法
1.1 检测对象 共37例，均无全身免疫性疾病史。分2组：青光眼组26例，男11例，女15例，年龄30～82a，平均66.5a；对照组为非青光眼的眼病患者，共11例，男2例，女9例，年龄23～75a，平均53.7a。26例青光眼患者中，有闭角型青光眼16例(其中急性闭角型青光眼3例，慢性闭角型青光眼13例)；开角型青光眼10例。
1.2 检测方法 IgG与IgM抗心磷脂抗体酶免疫(ELISA)试剂盒由上海第二医科大学科技中心实验室供应。采用抗心磷脂抗体酶免疫测定(ELISA)法，实验室专人检测抗心磷脂抗体。正常值：IgG ACA为1.00±0.39；IgM ACA为1.02±0.33。高于此值则为阳性。
2 结果
2.1 各组IgG抗心磷脂抗体的比较 青光眼组与对照组IgG ACA值比较有显著性差异(P＜0.05)，其中开角型青光眼组与对照组之IgG ACA值比较无显著性差异(P＞0.05)，闭角型青光眼组与对照组之IgG ACA值比较有显著性差异(P＜0.05)，见表1。开角型青光眼IgG ACA阳性率为20%，闭角型青光眼IgG ACA阳性率为37.5%.
表1 各组IgG抗心磷脂抗体(ACA)值比较
Table 1 Comparison of value of IgG ACA in every groups
| Groups |
Cases |
ACA |
t |
P |
| Glaucoma group |
26 |
27.94 |
2.46 |
＜0.05 |
| open-angle glaucoma |
10 |
10.22 |
2.00 |
＞0.05 |
| closure-angle glaucoma |
16 |
17.72 |
2.62 |
＜0.05 |
| Control group |
11 |
7.77 |
2.2 各组IgM抗心磷脂抗体的比较 青光眼组与对照组之IgM ACA比较有显著性差异(P＜0.05)，其中开角型青光眼与对照组之IgM ACA比较有显著性差异(P＜0.05)，闭角型青光眼与对照组之IgM ACA比较有显著性差异(P＜0.05)，见表2。开角型青光眼IgM ACA阳性率均为40%.闭角型青光眼IgM ACA阳性率为50%.
表2 各组IgM抗心磷脂抗体(ACA)值比较
Table 2 Comparison of value of IgM ACA in every groups
| Groups |
Cases |
ACA |
t |
P |
| Glaucoma |
26 |
42.95 |
2.25 |
＜0.05 |
| open-angle glaucoma |
10 |
13.06 |
2.90 |
＜0.05 |
| closure-angle glaucoma |
16 |
29.89 |
2.16 |
＜0.05 |
| Control group |
11 |
4.59 |
2.3 对照组IgG ACA与IgM ACA阳性率均为0。
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