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现已相信,系统性红斑狼疮(SLE)的病因涉及到自体免疫机制。患者血清内非器官特异性抗核抗体的存在率极高,其次是器官特异性抗体如抗甲状腺抗体、抗肾上腺抗体、抗胃壁细胞抗体和抗涎腺分泌导管抗体。亦有抗心脏组织抗体(HAB)的报告。虽然临床上对SLE累及心脏已有明确认识,但和其它器官特异抗体一样,HAB是心脏功能失调的原因或是结果则未能判明。本文报告具有和不具有心脏损害临床表现的SLE患者血清中HAB的出现情况。研究对象为女病人28例及男病人4例,平均年龄25岁,患病时间4周～20年。用间接免疫萤光法测定HAB的存在。同时还测定了抗核抗体(ANA)的存在。结果发现,所有患者均属ANA阳性,其滴度在1∶20或以上。32例SLE患者中有20例患者血清HAB阳性。根据临床体征和症状诊断累及心脏的患者有12例。HAB阳性者在累及心脏的患者中(12例中有8例)和未累及心脏的患者中(20例中有12例)的发生率相同。但在7例明显累及心脏的病例中则有6例的HAB为阳性。无一例患者的充血性心力衰竭系由高血压引起。对照组的HAB阳性率甚低,与SLE患者HAB阳性率间差别的显著性水平在P=0.01～0.001
It is now believed that the etiology of systemic lupus erythematosus (SLE) involves an autoimmune mechanism. The presence of non-organ specific antinuclear antibodies in patients’ sera is very high, followed by organ-specific antibodies such as anti-thyroid, anti-adrenal, anti-parietal and anti-salivary gland secretion catheters. There are also reports of anti-cardiac tissue antibodies (HABs). Although there is a clear clinical understanding of the involvement of SLE in the heart, HAB, like other organ-specific antibodies, is the cause of cardiac dysfunction or the result is not known. This article reports the presence of HAB in sera of SLE patients with and without clinical manifestations of cardiac damage. The study object was 28 female patients and 4 male patients, with an average age of 25 years old, the prevalence of 4 weeks to 20 years. Indirect immunofluorescence was used to determine the presence of HAB. The presence of anti-nuclear antibody (ANA) was also determined. The results showed that all patients are ANA-positive, the titer of 1:20 or more. Serum HAB was positive in 20 of 32 SLE patients. There were 12 patients diagnosed with heart involvement based on clinical signs and symptoms. HAB-positive patients had the same incidence of heart-affecting patients (8 of 12) and those without heart involvement (12 of 20). However, HAB was positive in 6 out of 7 cases of apparent cardiac involvement. None of the patients had congestive heart failure caused by hypertension. The positive rate of HAB in control group was very low, and the difference between HAB positive rate and SLE patients was significant at P = 0.01 ~ 0.001