Risk for venous thrombosis related to antiphospholipid antibodies in systemic lupus erythematosus—A meta-analysis
Risk for venous thrombosis related to antiphospholipid antibodies in systemic lupus erythematosus—A meta-analysis
复制标题
系统性红斑狼疮中与抗磷脂抗体相关的静脉血栓形成风险——一项荟萃分析
作者：
D. Wahl;F. Guillemin;E. Maistre;C. Perret;T. Lecompte;G. Thibaut
目的：目的探讨抗磷脂抗体（aPL）与系统性红斑狼疮（SLE）静脉血栓形成（VT）的相关性。设计：对26篇关于SLE患者aPL和VT相关性的文章进行系统回顾和荟萃分析。设置：主要是二级和三级转诊中心。患者：2249例SLE患者，1120例检测LA（狼疮抗凝剂），1563例检测aCL（抗心磷脂抗体）。主要观察指标：总结研究特征并对研究质量进行严格评价。对18项检查VT和LA相关性的主要研究和14项检查VT和aCL相关性的研究进行了两种统计组合，以估计与aPL相关的VT风险。结果如下：18项研究总结的与LA相关的VT风险的比值比总体为5.61 [95% CI; 3.80-8.27]，深静脉血栓形成和肺栓塞为6.32 [CI; 3.71-10.78]，首次事件后复发性静脉血栓形成为11.6 [3.65- 36.91]。14项研究总结的aCL相关VT风险的比值比总体为2.17 [95% CI; 1.51-3.11]，深静脉血栓形成和肺栓塞为2.50 [CI; 1.51-4.14]，首次事件后复发性静脉血栓形成为3.91 [1.14- 13.38]。结论：患有SLE和LA的患者发生VT的风险比没有LA的患者高约6倍，而患有SLE和aCL的患者发生VT的风险比没有aCL的患者高约2倍。我们已经确定了重要的方法学限制和研究特征的差异。在这些研究中，尚未彻底评价室性心动过速的其他风险因素。需要进一步的研究来提供aPL相关VT的绝对风险的准确估计。
Objective: To describe the relative risk for venous thrombosis (VT) associated with antiphos pholipid antibodies (aPL) in systemic lupus erythematosus (SLE). Design: Systematic review and meta-analysis of 26 articles that examined the association between aPL and VT in SLE. Setting: Mostly secondary and tertiary referral centres. Patients: 2249 patients with SLE, 1120 tested for LA (lupus anticoagulant) and 1563 tested for aCL (anticardiolipin antibodies). Main outcome measures: A summary of study characteristics and a critical appraisal of study quality were done. Two statistical combinations of 18 primary studies that examined the association of VT and LA and of 14 studies that examined the association of VT and aCL were performed to estimate the risk for VT associated with aPL. Results: The odds ratios of the risk of VT related to the LA summarized from 18 studies were 5.61 [95% CI; 3.80-8.27] overall, 6.32 [CI; 3.71-10.78] for deep venous thrombosis and pulmonary embolism, 11.6 [3.65--36.91] for recurrent venous thrombosis after the first event. The odds ratios of the risk of VT related to aCL summarized from 14 studies were 2.17 [95% CI; 1.51-3.11] overall, 2.50 [CI; 1.51-4.14] for deep venous thrombosis and pulmonary embolism, 3.91 [1.14- 13.38] for recurrent venous thrombosis after the first event. Conclusions: Patients with SLE and LA are at approximately six times greater risk for VT than patients without LA, whereas patients with SLE and aCL are approximately two times greater risk for VT than patients without aCL. We have identified important methodologic limitations and differences in study characteristics. Other risk factors for VT have not been thoroughly evaluated in these studies. Further studies are needed that provide an accurate estimate of the absolute risk for aPL related VT.
系统性红斑狼疮患者抗心磷脂抗体单次检测的临床意义。
DOI：
10.1016/s0002-9343(88)80229-8
发表时间：
1988
期刊：
The American journal of medicine
影响因子：
--
作者：
Kalunian,KC;Peter,JB;Middlekauff,HR;Sayre,J;Ando,DG;Mangotich,M;Hahn,BH
通讯作者：
Hahn,BH