Revised classification criteria for antiphospholipid syndrome and the thrombotic risk in patients with autoimmune diseases
Revised classification criteria for antiphospholipid syndrome and the thrombotic risk in patients with autoimmune diseases
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修订后的抗磷脂综合征分类标准和自身免疫性疾病患者的血栓形成风险
DOI：
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发表时间：
2007
影响因子：
10.4
通讯作者：
J. Musial
中科院分区：
文献类型：
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作者：
J. Swadźba;T. Iwaniec;Andrzej Szczeklik;J. Musial
总结。背景：2006年更新了抗磷脂综合征（APS）的分类标准。目的：本研究的目的是基于最近更新的标准，分析一组自身免疫性疾病患者APS典型的临床并发症和实验室检查异常之间的关系。患者/方法：336例患者被纳入研究，其中大多数（n = 235）患有系统性红斑狼疮。实验室检测包括：狼疮抗凝血剂（LA）、抗心磷脂（aCL）和抗β2糖蛋白I（抗β2GPI）抗体（ABs）[免疫球蛋白G （IgG）和IgM类]。结果：APS的实验室特征与临床特征显著相关；与LA、aCL和抗β2GPI抗体相关的血栓形成的优势比（or）分别为4.04 [95% CI: 2.44-6.68]、3.71 （95% CI: 2.32-5.92）和2.57 （95% CI: 1.60-4.1）。详细分析显示，IgG类抗体（aCL和抗β2GPI分别为OR 4.15, 95% CI 2.42-7.12和OR 4.77, 95% CI 2.37-9.61）和IgM类抗体（aCL和抗β2GPI分别为OR 2.2, 95% CI 1.31-3.70和OR 1.9, 95% CI 1.15-3.14）的临床并发症风险存在显著差异。假设将抗β2GPI抗体阳性纳入先前的实验室标准，仅轻微改变了APS诊断患者的数量（从112例到117例）。结论：更新后的APS分类标准明显是向前迈进了一步。然而，我们的研究结果反对使用aCL或抗β2GPI的总体阳性，并倾向于明确区分IgG和IgM类抗磷脂抗体。LA和抗β2GPI IgG或LA和aCL IgG阳性的患者可能代表血栓并发症风险最高的亚组。
Summary. Background: The classification criteria for antiphospholipid syndrome (APS) were updated in 2006. Objective: The aim of the study was to analyze associations between clinical complications and laboratory test abnormalities typical for APS in a group of patients with autoimmune diseases, based on the recently updated criteria. Patients/methods: Three hundred and thirty‐six patients were enrolled into the study, with the majority (n = 235) suffering from systemic lupus erythematosus. Laboratory determinations included: lupus anticoagulant (LA), anticardiolipin (aCL) and anti‐beta2‐glycoprotein I (anti‐β2GPI) antibodies (ABs) [of both immunoglobulin G (IgG) and IgM class]. Results: A significant association was found between laboratory and clinical features of APS; odds ratios (ORs) for thrombosis associated with the presence of LA, aCL, and anti‐β2GPI Abs were 4.04 [95% CI: 2.44–6.68], 3.71 (95% CI 2.32–5.92) and 2.57 (95% CI 1.60–4.1), respectively. Detailed analysis showed marked differences between the risk of clinical complications associated with the presence of an antibody in the IgG class (OR 4.15, 95% CI 2.42–7.12, and OR 4.77, 95% CI 2.37–9.61 for aCL and anti‐β2GPI, respectively) and in the IgM class (OR 2.2, 95% CI 1.31–3.70, and OR 1.9, 95% CI 1.15–3.14 for aCL and anti‐β2GPI, respectively). The postulated inclusion of anti‐β2GPI antibody positivity into the previous laboratory criteria changed only slightly the number of patients diagnosed with APS (from 112 to 117). Conclusions: The updated APS classification criteria clearly represent a step forward. However, our results argue against the use of overall positivity for aCL or anti‐β2GPI, and favor a clear distinction between the IgG and IgM classes of antiphospholipid ABs. Patients with both LA and anti‐β2GPI IgG or LA and aCL IgG positivity may represent the subgroups at the highest risk of thrombotic complications.
DOI：
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发表时间：
2006-09
期刊：
The Journal of rheumatology
影响因子：
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作者：
Adriana Danowski;T. Kickler;M. Petri
通讯作者：
Adriana Danowski;T. Kickler;M. Petri