ANTICARDIOLIPIN ANTIBODIES AND THE RISK FOR ISCHEMIC STROKE AND VENOUS THROMBOSIS
ANTICARDIOLIPIN ANTIBODIES AND THE RISK FOR ISCHEMIC STROKE AND VENOUS THROMBOSIS
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DOI：
10.7326/0003-4819-117-12-997
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发表时间：
1992-12-15
影响因子：
39.2
通讯作者：
STAMPFER, MJ
中科院分区：
文献类型：
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作者：
GINSBURG, KS;LIANG, MH;STAMPFER, MJ
目的：确定抗心磷脂抗体的存在是否是健康成年男性缺血性卒中和静脉血栓形成的危险因素。参与者：研究样本来自医生健康研究，这是一项在22071名男性医生中进行的阿司匹林和β-胡萝卜素的随机、双盲、安慰剂对照试验。在进入时，68%的参与者提交了随后在-80 ℃下冷冻的血浆样本。在60.2个月的随访期间，非致死性结局的随访完成率为99.7%，致死性结局的确定完成率为100%。我们确定了有记录的缺血性中风、腿部深静脉血栓形成或肺栓塞的男性，并为他们提供了血浆样本。对照组的年龄，吸烟史，和随访时间的100例缺血性中风和90例深静脉血栓形成或肺栓塞。测量：血浆样本进行了评估IgG抗心磷脂抗体的酶联免疫吸附试验。两个诊断组病例的抗心磷脂抗体平均滴度（缺血性中风;静脉血栓形成或肺栓塞）与对照组进行比较，并通过条件Logistic回归计算抗心磷脂抗体增加百分位数类别患者的相对风险。深静脉血栓形成和肺栓塞患者的抗心磷脂抗体滴度明显高于对照组（P = 0.01）。抗心磷脂抗体滴度高于第95百分位数的人发生深静脉血栓形成或肺栓塞的相对风险为5.3（95%CI，1.55 - 18.3; P = 0.01）。结论：抗心磷脂抗体水平高于第95百分位数是健康成年男性深静脉血栓形成或肺栓塞的重要危险因素，但与缺血性脑卒中无关。
Objective: To determine whether the presence of anticardiolipin antibodies is a risk factor for ischemic stroke and venous thrombosis in healthy adult men.Design: A nested, case-control study in a prospective cohort.Setting. A nationwide study of physicians.Participants: The study sample was drawn from the Physicians' Health Study, a randomized, double-blind, placebo-controlled trial of aspirin and beta-carotene in 22 071 male physicians. At entry, 68% of the participants submitted plasma samples that were subsequently frozen at -80-degrees-C. During 60.2 months of follow-up, follow-up for nonfatal outcomes was 99.7% complete and ascertainment of fatal outcomes was 100% complete. We identified men with documented ischemic stroke, deep venous thrombosis of the leg, or pulmonary embolus and for whom a plasma sample was available. A control was matched by age, smoking history, and length of follow-up to each of the 100 patients with ischemic stroke and the 90 patients with deep venous thrombosis or pulmonary embolus.Measurements: Plasma samples were assessed for IgG anticardiolipin antibodies by enzyme-linked immunosorbent assay. The mean anticardiolipin antibody titers of the case patients in the two diagnostic groups (ischemic stroke; venous thrombosis or pulmonary embolus) were compared with those of the control groups, and relative risks were calculated for patients in increasing percentile categories of anticardiolipin antibodies by conditional logistic regression.Results: The anticardiolipin antibody titers were higher in case patients with deep venous thrombosis and pulmonary embolus than in their matched controls (P = 0.01). Persons with anticardiolipin antibody titers above the 95th percentile had a relative risk for developing deep venous thrombosis or pulmonary embolus of 5.3 (95% Cl, 1.55 to 18.3; P = 0.01). The anticardiolipin antibody titers in case patients with ischemic stroke and controls were not significantly different (P > 0.2), and no clear trend of higher risks among those with elevated levels of anticardiolipin antibodies was observed.Conclusion: An anticardiolipin antibody level above the 95th percentile is an important risk factor for deep venous thrombosis or pulmonary embolus but not for ischemic stroke in healthy adult men.