Presence of Antiphospholipid Antibodies as a Risk Factor for Thrombotic Events in Patients with Connective Tissue Diseases and Idiopathic Thrombocytopenic Purpura
Presence of Antiphospholipid Antibodies as a Risk Factor for Thrombotic Events in Patients with Connective Tissue Diseases and Idiopathic Thrombocytopenic Purpura
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DOI：
10.2169/internalmedicine.55.5536
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发表时间：
2016-01-01
影响因子：
1.2
通讯作者：
Mizutani, Hitoshi
中科院分区：
文献类型：
--
作者：
Habe, Koji;Wada, Hideo;Mizutani, Hitoshi
目的 抗磷脂综合征（APS）是习惯性流产和/或血栓形成的常见并发症，常与自身免疫性疾病相关。方法我们回顾性研究了 147 例疑似 APS 的各种结缔组织病（CTD）患者和 86 例特发性血小板减少性紫癜患者中抗磷脂抗体（aPLs）的存在与血栓事件（THE）发生率之间的关系。 （ITP）。 41例患者中出现THE，其中静脉血栓14例，动脉血栓21例，妊娠并发症8例。结果系统性红斑狼疮（SLE）患者THE患病率明显高于其他CTD患者和ITP患者。与ITP患者相比，SLE患者狼疮抗凝物（LA）、抗心磷脂抗体（aCL）-β2-糖蛋白（GPI）复合物IgG和aPL的频率显着升高。随后，aPL 患者中 THE 的发生率明显较高。特别是，在携带 LA、aCL-β 2GPI IgG 或 aPL 的 SLE 或 ITP 患者中，THE 的发生率显着较高。与使用制造商提供的试剂盒获得的值相比，SLE 患者中 LA、aCL IgG 和 aCL-β 2GPI 复合物 IgG 的 THEs 风险最佳临界值较高。 结论 尽管 aPLs 经常与 SLE 相关并且是血栓形成的致病因素，但 aPL 预测 THEs 发生的最佳临界值因不同的基础疾病而异。
Objective Antiphospholipid syndrome (APS) is a well-known complication of habitual abortion and/or thrombosis and is frequently associated with autoimmune diseases.Methods We retrospectively investigated the relationships between the presence of antiphospholipid antibodies (aPLs) and the incidence of thrombotic events (THEs) in 147 patients with various connective tissue diseases (CTD) suspected of having APS and 86 patients with idiopathic thrombocytopenic purpura (ITP). THEs were observed in 41 patients, including 14 cases of venous thrombosis, 21 cases of arterial thrombosis and eight cases of complications of pregnancy.Results The prevalence of THE was significantly high in the systemic lupus erythematosus (SLE) patients compared with the other CTD patients and ITP patients. The frequency of lupus anticoagulant (LA), anticardiolipin antibodies (aCL)-beta 2-glycoprotein (GPI) complex IgG and aPL was significantly high in the SLE patients compared with the ITP patients. Subsequently, the rate of development of THE was significantly high in the patients with aPLs. In particular, the incidence of THE was significantly high in the SLE or ITP patients with LA, aCL-beta 2GPI IgG or aPL. The optimal cut-off values for LA, aCL IgG and aCL-beta 2GPI complex IgG for the risk of THEs were higher in the SLE patients in comparison to the values obtained when using the kit provided by the manufacturer.Conclusion Although aPLs is frequently associated with SLE and is a causative factor for thrombosis, the optimal cut-off value for aPL for predicting the occurrence of THEs varies among different underlying diseases.