抗核抗体与主动脉壁间血肿发生的相关性分析

doi:10.3969/j.issn.1674-490X.2022.05.004

摘要/Abstract

摘要： 目的探讨抗核抗体(antinuclear antibodies, ANAs)与主动脉壁间血肿(variants intramural hematoma, IMH)发生的相关性。方法选取2018年11月至2020年7月就诊于心脏血管外科诊断为IMH的患者88例为试验组。对照组由88例同期年龄匹配的胸痛患者且经主动脉增强CT证实无急性主动脉综合征患者组成。所有患者入院后第1天空腹检测外周血ANAs水平,应用免疫荧光法检测ANAs,滴度>1∶100为阳性。结果 88例对照组受试者中,16例(18.18%)ANAs阳性,3例(3.41%)抗中性粒细胞胞质抗体(antineutrophil cytoplasmic antibodies, ANCA)阳性,88例试验组中,48例(54.55%)ANAs阳性,12例(13.64%)ANCA 阳性,2组间差异有统计学意义。经二元Logistic回归分析,动脉粥样硬化(OR=7.439,95%CI=1.319~41.965,P=0.023)、白细胞计数(OR=2.907,95%CI=1.812~4.663,P=0.001)、D-二聚体(OR=2.942,95%CI=1.406~6.154,P=0.004)、ANAs(OR=13.618, 95%CI=2.437~76.085,P=0.003)和ANCA(OR=0.064,95%CI=0.005~0.839,P=0.036)是IMH的独立危险因素。结论 ANAs阳性患者在IMH患者中的比例高于在对照组患者中的比例,且 ANAs为IMH独立危险因素,可能成为IMH重要的标志物。

关键词: 主动脉壁间血肿, 抗核抗体, 炎症反应, 动脉粥样硬化

Abstract: Objective To investigate the correlation of the incidence of anti-nuclear antibodies(ANAs)positivity and variants intramural hematoma(IMH). Methods 88 patients with a confirmed diagnosis of IMH admitted between November 2018 and July 2020 to Cardiovascular Surgery Department were included as the study group. The control group consisted of 88 age-matched chest pain patients without acute aortic syndrome confirmed by enhanced aortic CT. All patients were tested for ANAs in peripheral blood on the first day after admission. ANAs were detected by immunofluorescence assay. Titers > 1∶100 were regarded as positive for ANAs. Results Among the control subjects, 16(18.18%)were ANAs positive, 3(3.41%)were anti-neutrophil cytoplasmic antibodies(ANCA)positive, and among the study subjects, 48(54.55%)were ANAs positive, 12(13.64%)were ANCA positive.The difference between the two groups was statistically significant. Binary logistic regression analysis showed that atherosclerosis(OR=7.439, 95%CI=1.319-41.965, P=0.023), WBC(OR=2.907, 95%CI=1.812-4.663, P=0.001), D-Dimer(OR=2.942, 95%CI=1.406-6.154, P=0.004), ANAs(OR=13.618, 95% CI=2.437-76.085, P=0.003)and ANCA(OR=0.064, 95% CI=0.005-0.839, P=0.036)were independent risk factors for IMH. Conclusion The proportion of ANAs-positive patients in IMH group is higher than that in control group, and ANAs is an independent risk factor of IMH, which may become an important marker of IMH.

Key words: variants intramural hematoma, antinuclear antibodies, inflammation, atherosclerosis

中图分类号:

张静波, 史坚, 杨静云, 冉继鹏, 刘子腾, 张莎莎. 抗核抗体与主动脉壁间血肿发生的相关性分析[J]. 医学研究与教育, 2022, 39(5): 19-24.

ZHANG Jingbo, SHI Jian, YANG Jingyun, RAN Jipeng, LIU Ziteng, ZHANG Shasha. Correlational analyses between the production of anti-nuclear antibodies and biomarkers of variants intramural hematoma[J]. Journal of Hebei Medical College for Continuing Education, 2022, 39(5): 19-24.

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