Cerebrovascular ischemic events with high positive anticardiolipin antibodies.
Cerebrovascular ischemic events with high positive anticardiolipin antibodies.
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抗心磷脂抗体高阳性的脑血管缺血事件。
DOI：
10.1161/01.str.29.11.2245
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发表时间：
1998
期刊：
影响因子：
8.3
通讯作者：
Tietjen,GE
中科院分区：
文献类型：
--
作者：
Verro,P;Levine,SR;Tietjen,GE
背景和目的--我们研究的目的是研究抗心磷脂抗体(&GPL；100)高阳性患者的临床资料和预后价值。方法：我们研究了>；100 GPL抗体阳性患者的临床、实验室、放射学和前瞻性的历史特征。从我们的神经内科，27名患者被前瞻性地识别和随访(平均随访时间34个月)。结果：我们队列的平均年龄为41岁。3例出现狼疮样病变；23例有原发性抗磷脂综合征，其中3例符合Sneddon综合征标准；1例为进行性系统性硬化症。74%的患者发生脑梗塞，37%的患者复发。全身性缺血事件，最常见的深静脉血栓形成，发生在37%。85%的患者吸烟，74%的患者患有高脂血症，44%的患者患有高血压，7%的患者患有糖尿病。67%的患者有明显的头痛病史。72%的患者出现狼疮抗凝剂(LA)，大约一半的患者抗核抗体和血小板减少阳性，四分之一的患者VDRL假阳性。我们比较了抗磷脂综合征特定实验室特征检测阳性患者和这些参数检测阴性患者的平均GPL水平。仅LA(+)组的平均GPL显著高于LA(-)组(P=0.006)。脑成像显示非腔隙性脑梗塞占73%，腔隙占12%。19例脑血管造影中，大血管闭塞5例(26%)，分支梗阻6例(32%)。超声心动图异常率为75%，左侧瓣膜增厚为33%，赘生物为12%。96%的人观察到反复发生的脑血管缺血事件，其中暂时性事件(平均发生率，25%/年)发生的频率是中风(平均发生率，5%/年)的5倍。使用标准化的残疾程度量表，如果不考虑前交叉韧带的滴度，神经功能损害严重的占7%，中度的占30%，轻度或不存在的占63%，与平均GPL值无关(P=0.567)。个别患者的滴度波动很大，大多数患者的检测结果并不总是高度阳性。对症状严重程度的波动与并发的GPL值的分析没有显示出统计学上的显著相关性。与阳性滴度范围广泛的历史对照组相比，高Ig G ACL滴度的存在并不意味着残疾和复发的缺血性事件的预后更差。结论--我们的数据表明，与GPL高阳性相关的脑血管事件通常是多发性的和轻微的(与残疾滴度无关)，存在于相对年轻的患者中，并且经常与烟草滥用、高脂血症、LA、全身性缺血事件和隐匿性心脏病有关。
Background and Purpose—The aim of our study was to characterize the patient profile and prognostic value associated with high positive IgG (>100 GPL) anticardiolipin antibodies (aCL).Methods—We studied the clinical, laboratory, radiological, and prospective historical features of ischemic cerebrovascular disease in patients with >100 GPL titers. From our neurology department, 27 consecutive patients were prospectively identified and followed up (mean follow-up time, 34 months).Results—The mean age of our cohort was 41 years. Lupuslike illness occurred in 3; 23 had primary antiphospholipid syndrome, including 3 who met criteria for Sneddon’s syndrome; 1 patient had progressive systemic sclerosis. Cerebral infarcts occurred in 74% and were recurrent in 37%. Systemic ischemic events, most commonly deep vein thrombosis, occurred in 37%. Tobacco use was documented in 85%, hyperlipidemia in 74%, hypertension in 44%, and diabetes mellitus in 7% of patients. A prominent headache history was present in 67%. Lupus anticoagulant (LA) was present in 72%, approximately one half had positive antinuclear antibodies and thrombocytopenia, and one quarter had a false-positive VDRL. We compared mean GPL levels in patients testing positive for specific laboratory features of antiphospholipid syndrome with those testing negative for these parameters. Only the LA(+) group had a significantly higher mean GPL than the LA(-) group (P=0.006). Brain imaging showed nonlacunar infarcts in 73% and lacunes in 12%. Of 19 cerebral angiograms, 5 (26%) showed large-vessel occlusive disease and 6 (32%) branch obstruction. Echocardiograms were abnormal in 75%: thickened left-sided valves in 33% and vegetations in 12%. Recurrent cerebrovascular ischemic events were observed in 96%, with transient events (mean rate, 25%/y) occurring 5 times more frequently than strokes (mean rate, 5%/y). Using a standardized disability scale blinded to aCL titer, neurological impairment was severe in 7%, moderate in 30%, and mild or nonexistent in 63%, and unrelated to mean GPL value (P=0.567). Titers fluctuated greatly for individual patients, and most did not consistently test as highly positive. An analysis of fluctuation in symptom severity with concurrent GPL values did not show a statistically significant correlation. Compared with historical controls having a wide range of positive titers, the presence of high IgG aCL titers did not confer a worse prognosis for disability and recurrent ischemic events.Conclusions—Our data suggest that cerebrovascular events associated with high positive GPL are frequently multiple and minor (with no disability-titer correlation), present in relatively young patients, and often associated with tobacco abuse, hyperlipidemia, LA, systemic ischemic events, and occult cardiac disease.
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与抗磷脂抗体相关的脑血管疾病的临床、放射学和病理学方面
DOI：
--
发表时间：
1993
期刊：
影响因子：
--
作者：
S. Kittner;C. Joseph;S. Levine;K. Sawaya;L. Palm;J. Carey;M. J. Deegan;R. Brey;W. Davis;J. Kaste;D. Mcglasson;R. Mcatee;E. Feldmann;K. Friedberg;Barney J. Stem;P. Karanjia;D. Jacobson;Sandra Lobner;D. Hess;R. Adams;J. Weinberger;M. Dunn;D. Horowitz;S. Tuhrim;P. Fayad;L. Brass;T. Hwang;Antonio Trijillano;V. Babikian;Harry Hersey;M. Sloan;D. Fetzer;B. Coull;D. Briley;P. deGarmo;C. Gómez;M. Jedlicka;M. Fisher;E. M. Doyle;D. DeWitt
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D. DeWitt
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影响因子：
6.7
作者：
O. Vaarala;M. Puurunen;M. Mänttäri;V. Manninen;K. Aho;T. Palosuo
通讯作者：
T. Palosuo
影响因子：
4.6
作者：
S. Loizou;J. Mccrea;A. Rudge;R. Reynolds;C. Boyle;E. Harris
通讯作者：
S. Loizou;J. Mccrea;A. Rudge;R. Reynolds;C. Boyle;E. Harris
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：
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作者：
Kalunian,KC;Peter,JB;Middlekauff,HR;Sayre,J;Ando,DG;Mangotich,M;Hahn,BH
通讯作者：
Hahn,BH
抗磷脂酰乙醇胺抗体为唯一的抗磷脂抗体。
影响因子：
3.9
作者：
M. Bérard;R. Chantome;A. Marcelli;M. Boffa
通讯作者：
M. Boffa