Antibodies to phosphatidylserine/prothrombin (aPS/PT) enhanced the diagnostic performance in Chinese patients with antiphospholipid syndrome
Antibodies to phosphatidylserine/prothrombin (aPS/PT) enhanced the diagnostic performance in Chinese patients with antiphospholipid syndrome
复制标题
磷脂酰丝氨酸/凝血酶原 (aPS/PT) 抗体增强了中国抗磷脂综合征患者的诊断性能
DOI：
10.1515/cclm-2017-0811
复制
发表时间：
2018
影响因子：
6.8
通讯作者：
Li Yongzhe
中科院分区：
文献类型：
--
作者：
Zhang Shulan;Wu Ziyan;Zhang Wen;Zhao Jiuliang;Norman Gary L;Zeng Xiaofeng;Zhang Fengchun;Li Yongzhe
摘要背景：越来越多的证据强调了非标准抗磷脂抗体（aPL）作为诊断抗磷脂综合征（APS）的现行标准aPL的重要补充的作用。在这项回顾性研究中，我们评估了中国APS患者中磷脂酰丝氨酸/凝血酶原（aPS/PT）抗体的临床相关性。研究方法：共检测了441例受试者，包括101例原发性APS（PAPS）患者，140例继发性APS（SAPS）患者，161例疾病对照（DC）和39例健康对照（HC）。ELISA法测定血清IgG/IgM、aPS/PT。结果：APS患者IgG/IgM、aPS/PT水平明显高于DC和HC。IgG和IgM aPS/PT在PAPS和SAPS中的阳性率分别为29.7%和54.5%和42.1%和53.6%。IgG aCL诊断APS的阳性似然比（LR+）最高，为21.60，其次为LA（13.84）、IgG aβ 2GP 1（9.19）和IgG aPS/PT（8.49）。在血清阴性的PAPS和SAPS患者中，aPS/PT的检出率分别为13.3%和31.3%。LA对血栓形成的OR值最高（3.64），其次是IgG aCL（OR值2.63）、IgG aPS/PT（OR值2.55）和IgG aβ 2GP 1（OR值2.33）。LA和IgG aCL与动脉和静脉血栓形成均相关，而IgG aPS/PT和IgG aβ 2GP 1分别与静脉或动脉血栓形成相关。结论：我们的研究结果表明，包括IgG/IgM aPS/PT可能会提高APS的诊断性能，特别是在那些高度怀疑APS，但常规aPL反复阴性的患者中。此外，IgG aPS/PT可能有助于识别有血栓形成风险的患者。
Abstract Background: Increasing evidence has highlighted the role of non-criteria antiphospholipid antibodies (aPLs) as important supplements to the current criteria aPLs for the diagnosis of antiphospholipid syndrome (APS). In this retrospective study, we evaluated the clinical relevance of antibodies to phosphatidylserine/prothrombin (aPS/PT) in Chinese patients with APS. Methods: A total of 441 subjects were tested, including 101 patients with primary APS (PAPS), 140 patients with secondary APS (SAPS), 161 disease controls (DCs) and 39 healthy controls (HCs). Serum IgG/IgM aPS/PT was determined by ELISA. Results: The levels of IgG/IgM aPS/PT were significantly increased in patients with APS compared with DCs and HCs. IgG and IgM aPS/PT were present in 29.7% and 54.5% of PAPS, and 42.1% and 53.6% of SAPS, respectively. For diagnosis of APS, IgG aCL exhibited the highest positive likelihood ratio (LR+) of 21.60, followed by LA (13.84), IgG aβ2GP1 (9.19) and IgG aPS/PT (8.49). aPS/PT was detected in 13.3% of seronegative PAPS patients and 31.3% of seronegative SAPS patients. LA exhibited the highest OR of 3.64 in identifying patients with thrombosis, followed by IgG aCL (OR, 2.63), IgG aPS/PT (OR, 2.55) and IgG aβ2GP1 (OR, 2.33). LA and IgG aCL were correlated with both arterial and venous thrombosis, whereas IgG aPS/PT and IgG aβ2GP1 correlated with venous or arterial thrombosis, respectively. Conclusions: Our findings suggest that the inclusion of IgG/IgM aPS/PT may enhance the diagnostic performance for APS, especially in those in whom APS is highly suspected, but conventional aPLs are repeatedly negative. In addition, IgG aPS/PT may contribute to identify patients at risk of thrombosis.