Real world experience with antiphospholipid antibody tests: how stable are results over time?
Real world experience with antiphospholipid antibody tests: how stable are results over time?
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DOI：
10.1136/ard.2004.031856
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发表时间：
2005-09-01
影响因子：
27.4
通讯作者：
Lockshin, MD
中科院分区：
文献类型：
--
作者：
Erkan, D;Derksen, WJM;Lockshin, MD
目的：在大量评估良好的抗磷脂抗体（aPL）阳性患者中，确定抗磷脂抗体（aPL）结果随时间的稳定性和变化程度；并在多个实验室进行aPL测试的现实环境中分析导致aPL变化的因素和aPL的有效性。方法：分析204例aPL阳性患者狼疮抗凝血剂（LA）、抗心磷脂抗体（aCL）、抗β(2)糖蛋白I抗体（anti- β (2)GPI）的临床特点、药物治疗及1652个数据点；其中81例符合Sapporo抗磷脂综合征（APS）标准，123例为无症状aPL携带者。结果：87%的LA初始阳性结果，88%的aCL初始阴性到低阳性结果，75%的aCL初始中等到高阳性结果，96%的抗β (2)GPI初始阴性到低阳性结果，76%的抗β (2)GPI初始中等到高阳性结果随后保持在相同的范围内，无论实验室进行测试。在aCL滴度显著降低或升高或保持稳定的患者中，阿司匹林、华法林和羟氯喹的使用没有差异。在同一天样品中，供应商间aCL结果的一致性在64% ~ 88%之间，相关性在0.5 ~ 0.8之间。aCL IgG和aCL IgM的一致性中等；然而，对于aCL， IgA协议是边际的。结论：无论在哪个实验室进行检测，aPL结果在至少四分之三的后续检测中保持稳定；发生的少量变化似乎不是由阿司匹林、华法林或羟氯喹的使用引起的。
Objective: To determine the stability and the degree of variation of antiphospholipid antibody (aPL) results over time in a large cohort of well evaluated aPL positive patients; and to analyse factors contributing to aPL variation and the validity of aPL in a real world setting in which aPL tests are done in multiple laboratories.Methods: The clinical characteristics, drug treatment, and 1652 data points for lupus anticoagulant ( LA), anticardiolipin antibodies (aCL), and anti-beta(2) glycoprotein I antibodies (anti-beta(2)GPI) were examined in 204 aPL positive patients; 81 of these met the Sapporo criteria for antiphospholipid syndrome (APS) and 123 were asymptomatic bearers of aPL.Results: 87% of initially positive LA results, 88% of initially negative to low positive aCL results, 75% of initially moderate to high positive aCL results, 96% of initially negative to low positive anti-beta(2)GPI results, and 76% of initially moderate to high positive anti-beta(2)GPI results subsequently remained in the same range regardless of the laboratory performing the test. Aspirin, warfarin, and hydroxychloroquine use did not differ among patients whose aCL titres significantly decreased or increased or remained stable. On same day specimens, the consistency of aCL results among suppliers ranged from 64% to 88% and the correlation ranged from 0.5 to 0.8. Agreement was moderate for aCL IgG and aCL IgM; however, for aCL IgA agreement was marginal.Conclusions: aPL results remained stable for at least three quarters of subsequent tests, regardless of the laboratory performing the test; the small amount of variation that occurred did not appear to be caused by aspirin, warfarin, or hydroxychloroquine use.