從ß2醣蛋白I抗體之觀點分析抗磷脂質症候群

The clinical signifi cance of anti-β2-glycoprotein I antibody in antiphospholipid syndrome

目的：研究β2醣蛋白I抗體是否為抗磷脂質症候群之重要致病抗體。方法：我們從臺大醫院風濕免疫科之檢驗資料庫中，從西元2006年到2010年間，找出18位只有β2醣蛋白I抗體持續呈陽性之病患，並記錄其抗體效價還有臨床症狀。結果：此18位病患共記錄到24項臨床症狀。18位病患之中，有7位（38%）以反覆性流產表現；有6位（33%）以神經精神系統疾病表現。其抗體效價與臨床症狀間並無明顯關聯。結論：β2醣蛋白I抗體為抗磷脂質症候群之重要致病抗體。不僅有多於三分之一的持續性陽性抗體病患，表現出典型的抗磷脂質症候群症狀，且有相當比例之病患表現出神經精神系統疾病症狀。

Objective: To determine whether anti-β2-glycoprotein I per se plays a specifically pathogenic role in antiphospholipid syndrome. Methods: From January 2006 to December 2010, we analyzed the laboratory results from the data bank of Rheumatology Clinical Lab of the National Taiwan University hospital and selected 17 patients with isolated persistent positive anti-β2GPI. We recorded these patients’ clinical symptoms and signs and autoantibody titer. Results: Among the 17 patients, totally 25 events were recorded. 7 out of 25 (28%) events were repeated miscarriage and 6 out of 25 (24%) events were neuropsychiatric symptoms. There is no statistically signifi cance between the unique symptoms and autoantibody titer. Conclusion: Anti-β2-glycoprotein I does play a specific role in antiphospholipid syndrome. Besides typical criteria manifestation, there are a number of patients present with neuropsychiatric disorder which should be important.