Elevated partial antiphospholipid score is a strong risk factor for thrombosis in patients with systemic lupus erythematosus: a validation study
Elevated partial antiphospholipid score is a strong risk factor for thrombosis in patients with systemic lupus erythematosus: a validation study
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部分抗磷脂评分升高是系统性红斑狼疮患者血栓形成的重要危险因素：一项验证研究
DOI：
10.1007/s10067-015-3159-8
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发表时间：
2016-02-01
影响因子：
3.4
通讯作者：
Fu, Qiong
中科院分区：
文献类型：
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作者：
Chen, Jie;Sun, Shuhui;Fu, Qiong
本研究旨在确定系统性红斑狼疮（SLE）患者血栓形成的危险因素，并验证部分抗磷脂（aPL）评分在血栓预测以及抗磷脂综合征（APS）诊断中的有效性。本研究纳入325例SLE患者，其中188例完成了31.01个月（范围23 - 48个月）的随访。部分aPL评分是通过将活化部分凝血活酶时间（APTT）、狼疮抗凝物、IgG/IgM抗心磷脂抗体（aCL）以及IgG/IgM抗β2 - 糖蛋白I（抗β2GPI）的各项评分相加得出。简化的aPL评分仅使用APTT、IgG/IgM aCL和IgG/IgM抗β2GPI制定。有血栓形成的SLE患者的部分aPL评分显著更高（p < 0.0001）。有血栓形成病史（p < 0.0001）、部分aPL评分>10（p < 0.0001）以及使用免疫抑制剂（p = 0.012）是血栓形成的独立危险因素。对于有血栓形成病史的患者，部分aPL评分是复发性血栓形成的最强危险因素（p < 0.0001，优势比 = 30.34（95%置信区间7.70 - 118.81））。对于APS诊断，使用部分aPL评分时，受试者工作特征曲线下面积（AUC）为0.809（95%置信区间0.73 - 0.89）。同样，简化的aPL评分与血栓形成显著相关（p < 0.0001），并且对于APS诊断是可接受的（AUC 0.797，95%置信区间0.72 - 0.88）。部分aPL评分升高是SLE患者血栓形成的强危险因素，是预测复发性血栓形成的有用工具。部分aPL评分和简化的aPL评分虽然比原始aPL评分包含的项目少，但也是APS诊断有价值的定量指标。
This study aims to identify risk factors for thrombosis in patients with systemic lupus erythematosus (SLE) and to validate the efficacy of the partial antiphospholipid (aPL) score for thrombosis prediction and diagnosis of antiphospholipid syndrome (APS). This study included 325 SLE patients, 188 of whom completed a follow-up of 31.01 months (range 23–48 months). Partial aPL score was calculated by adding up the individual scores for activated partial thromboplastin time (APTT), lupus anticoagulant, IgG/IgM anticardiolipin antibodies (aCL), and IgG/IgM anti-β2-glycoprotein I (anti-β2GPI). A simplified aPL score was developed using only APTT, IgG/IgM aCL, and IgG/IgM anti-β2GPI. Partial aPL scores were significantly higher in SLE patients with thrombosis (p< 0.0001). A history of thrombosis (p< 0.0001), a partial aPL score >10 (p< 0.0001), and immunosuppressant use (p= 0.012) were independent risk factors for thrombosis. For patients with a history of thrombosis, partial aPL score was the strongest risk factor for recurrent thrombosis (p< 0.0001, odds ratio = 30.34 (95 % CI 7.70–118.81)). For APS diagnosis, the area under the receiver-operating characteristic curve (AUC) was 0.809 (95 % CI 0.73–0.89) using the partial aPL score. Similarly, the simplified aPL score was significantly associated with thrombosis (p< 0.0001) and was acceptable for APS diagnosis (AUC 0.797, 95 % CI 0.72–0.88). An elevated partial aPL score is a strong risk factor for thrombosis in SLE patients and is a useful tool to predict recurrent thrombosis. Partial aPL score and simplified aPL score, although comprising fewer items than the original aPL score, also represent valuable quantitative indices for APS diagnosis.