中文摘要：

目的提取和鉴定人血清中氧化脂蛋白（a）[ox-Lp（a）]自身抗体，建立ox-Lp（a）ELISA检测法并进行临床研究。方法采用溴化氰活化的sepharose4B交联ox-Lp（a）制备免疫吸附层析柱，从正常人血清中提取抗ox-Lp（a）自身抗体，分析其免疫反应性。分别建立以抗ox-Lp（a）的自身抗体、抗氧化LDL（ox-LDL）多克隆抗体为包被抗体，酶标抗载脂蛋白（a）[apo（a）]为检测抗体的ox-Lp（a）ELISA检测法，并对100例冠心病患者和100名健康体检人群进行分析。结果8份正常人血清中均存在抗ox-Lp（a）自身抗体，与ox-Lp（a），ox-LDL均具有良好的反应性；再经亲和层析除出抗ox-LDL自身抗体后，2份标本同ox-Lp（a）仍具有较高的反应性。同对照组相比，本组冠心病患者血浆Lp（a）水平显著升高[（279．6±162．7）mg／L比（206．3±126．4）mg／L，P〈0．01]；ox-Lp（a）水平亦明显增加（P〈0．01），采用自身抗体和抗ox-LDL抗体建立的ELISA法测定结果分别为：（24．3±33．4）μg/ml比（8．4±9．3）μ/ml和（13．0±13．8）μ/ml比（7．3±9．7）μ/ml；两种ELISA法间结果高度相关（r=0．78，P〈0．01）。结论提取的人血清ox-Lp（a）自身抗体可识别apo（a）和apoB氧化位点，采用自身抗体建立的ox-Lp（a）检测法能更真实、准确地反应体内Lp（a）的氧化状态，冠心病患者ox-Lp（a）水平显著升高。

英文摘要：

Objective To isolate and identify human autoantibodies against oxidized Lp（a） [ ox-Lp （a） ] and develop new ELISA method for ox-Lp （a） by using isolated human autoantibodies as capture antibody. Methods Ox-Lp（a） autoantibodies from healthy subjects were isolated and identified by affinity chromatography. Two ＂sandwich＂ ELISA methods for plasma ox-Lp（a） were developed by using either the human autoantibodies against ox-Lp（a） or rabbit antiserum against human ox-LDL as the capture antibodies. Enzyme-labeled monoclonal anti-ape（a） was used for the quantifications. Serum ox-Lp （a） levels in 100 coronary heart disease （CHD） patients and 100 control subjects were measured with the ELISA methods. Results Ox-Lp（a） autoantibodies were isolated from all 8 studied subjects. Autoantibodies from two of the 8 sebjects showed both reactivities to ox-LDL and ox-apo（a）. The Lp（a） levels in the patients with CHD were significantly different from those of control [ （279. 6 ± 162.7 ） mg/L vs （206. 3 ± 126. 4 ） mg/L, P 〈 0.0 1 ]. Plasma ox-Lp（a） levels in patients with CHD detected by two ELISAs were both significantly higher than those of control [ ELISA using human antibodies against ox-Lp（a） ： （24.3 ± 33.4） μg/ml vs （8.4 ± 9. 3 ） μg/ml, P 〈 0.01 ; ELISA using antibodies against ox-LDL： （ 13.0 ± 13.8 ） μg/ml vs （7. 3 ±9.7） μg/ml, P 〈 0. 01, respectively]. Results obtained with the two ELISA methods were closely correlated （r = 0. 78, P 〈 0. 01 ）. Conclusions Autoantibodies against ox-Lp （a） can recognize both ape （a） and apoB epitopes of ox-Lp （a）. A new ELISA for ox-Lp （a） by using human antibodies has been developed. Increased serum ox-Lp（a） has been observed in the CHD patients.