Antiphospholipid Antibodies, Haemostatic Variables and Thrombosis – A Survey of 144 Patients
Antiphospholipid Antibodies, Haemostatic Variables and Thrombosis – A Survey of 144 Patients
复制标题
抗磷脂抗体、止血变量和血栓形成 – 对 144 名患者的调查
DOI：
10.1055/s-0038-1653866
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发表时间：
1995
影响因子：
6.7
通讯作者：
V. Brancaccio
中科院分区：
文献类型：
--
作者：
P. Ames;S. Pyke;L. Iannaccone;V. Brancaccio
几种凝血异常已被提出来解释抗磷脂综合征的血栓形成倾向，但纤维蛋白原和血管性血友病因子的可能作用研究甚少。本横断面回顾性研究评价了IgG抗心磷脂抗体、狼疮抗凝剂、纤维蛋白原和血管性血友病因子与抗磷脂抗体患者动脉和静脉血栓形成的关系。在检测狼疮抗凝剂的凝血试验中，稀释的罗素蝰蛇毒时间与静脉血栓形成史的相关性比活化的部分凝血活酶时间更强（p <0.0002 vs p <0.009），并且是唯一与动脉血栓形成史相关的试验（p <0.01），也是在低水平的IgG抗心磷脂抗体（p = 0.003）下。通过回归分析，校正混杂因素后，发现血清IgG抗心磷脂抗体水平与静脉事件数量呈正相关（p <0.001）。血浆纤维蛋白原和血管性血友病因子水平彼此相关（p <0.0001; r：0.48），并与动脉和静脉血栓形成的发生相关（p <0.001）。此外，血浆纤维蛋白原和血管性血友病因子水平的血栓形成患者与抗磷脂抗体显着高于血栓形成的其他原因的血栓形成患者的对照组（分别为p <0.0001和p = 0.0008）。IgG抗心磷脂抗体滴度与血浆血管性血友病因子水平相关（p <0.0001; r：0.42）。这些发现支持了这样的假设，即在抗磷脂抗体家族中，存在可能优先与动脉或静脉闭塞相关的亚组，并提高了纤维蛋白原和血管性血友病因子血浆水平升高可能通过血管内皮的参与参与抗磷脂综合征的血栓形成倾向的可能性，正如IgG抗心磷脂和血管性血友病因子之间的关系所示。在前瞻性研究中，除了抗心磷脂抗体和狼疮抗凝剂外，测定纤维蛋白原和血管性血友病因子可能有助于评估抗磷脂抗体患者发生动脉和静脉血栓形成的风险。
Summary Several clotting abnormalities have been put forth to explain the thrombotic tendency of the antiphospholipid syndrome, but a possible role for fibrinogen and von Willebrand factor has been poorly investigated. The present cross-sectional retrospective study evaluated the relationship of IgG anticardiolipin antibodies, lupus anticoagulants, fibrinogen and von Willebrand factor with the occurrence of arterial and venous thromboses in patients with antiphospholipid antibodies. Among the clotting assays for the detection of lupus anticoagulant, dilute Russell’s viper venom time correlated with a history of venous thrombosis more strongly than activated partial thromboplastin time (p <0.0002 vs p <0.009) and was the only test which correlated with a history of arterial thrombosis (p <0.01), also at low levels of IgG anticardiolipin antibodies (p = 0.003). By regression analysis, and after correction for confounders, serum levels of IgG anticardiolipin antibodies were found to be positively associated with the number of venous events (p <0.001). Plasma levels of fibrinogen and von Willebrand factor were associated with each other (p <0.0001; r: 0.48) and with the occurrence of arterial and venous thromboses (p <0.001). Moreover, plasma levels of fibrinogen and von Willebrand factor in thrombotic patients with antiphospholipid antibodies were significantly higher than those of a control group of thrombotic patients who suffered thrombosis for other reasons (p <0.0001 and p = 0.0008 respectively). Titres of IgG anticardiolipin antibodies correlated with plasma levels of von Willebrand factor (p <0.0001; r: 0.42). These findings support the hypothesis that within the antiphospholipid antibody family, subgroups exist which may preferentially associate with arterial or venous occlusions and raise the possibility that elevated plasma levels of fibrinogen and von Willebrand factor may be implicated in the thrombotic tendency of the antiphospholipid syndrome through an involvement of the vascular endothelium, as the relationship between IgG anticardiolipin and von Willebrand factor suggests. Measurement of fibrinogen and von Willebrand factor in prospective studies, besides anticardiolipin antibodies and lupus anticoagulants, may help assess the risk of developing arterial and venous thrombosis in patients with antiphospholipid antibodies.
影响因子：
20.3
作者：
P. Thiagarajan;V. Pengo;S. Shapiro
通讯作者：
P. Thiagarajan;V. Pengo;S. Shapiro
DOI：
10.1001/jama.1987.03400090067035
发表时间：
1987-09
期刊：
JAMA
影响因子：
--
作者：
W. Kannel;P. Wolf;W. Castelli;R. D'Agostino
通讯作者：
W. Kannel;P. Wolf;W. Castelli;R. D'Agostino