Brey Robin L, Stallworth Christian L, McGlasson David L, Wozniak Marcella A, Wityk Robert J, Stern Barney J, Sloan Michael A, Sherwin Roger, Price Thomas R, Macko Richard F, Johnson Constance J, Earley Christopher J, Buchholz David W, Hebel J Richard, Kittner Steven J
University of Texas Health Science Center, San Antonio, Tex 78229-3900, USA.
Stroke. 2002 Oct;33(10):2396-400. doi: 10.1161/01.str.0000031927.25510.d1.
Antiphospholipid antibodies have been associated with ischemic stroke in some but not all studies.
We performed a population-based case-control study examining antiphospholipid antibodies (anticardiolipin antibodies and lupus anticoagulants) using stored frozen sera and plasma in 160 cases and 340 controls enrolled in the Stroke Prevention in Young Women study. We evaluated for the presence of anticardiolipin antibody (IgG, IgM, and IgA isotypes) by an enzyme-linked immunosorbent assay and for the lupus anticoagulant using several phospholipid-dependent coagulation tests (activated partial thromboplastin time, dilute Russell's viper venom time) with mixing studies. If mixing studies were prolonged, confirmatory tests were performed.
A positive anticardiolipin antibody level of any isotype was seen in 43 cases (26.9%) and 62 controls (18.2%) (P=0.03), lupus anticoagulant in 29 cases (20.9%) and 38 controls (12.8%) (P=0.03), and either anticardiolipin antibody or lupus anticoagulant in 61 cases (42.1%) and 86 controls (27.9%) (P=0.003). After adjustment for age, current cigarette smoking, hypertension, diabetes, angina, ethnicity, body mass index, and high-density lipoprotein levels, the relative odds of stroke for women with anticardiolipin antibody immunoreactivity of any isotype or a lupus anticoagulant was 1.87 (95% confidence interval, 1.24 to 2.83; P=0.0027).
The results from this study support the importance of antiphospholipid antibodies as an independent risk factor for stroke in young women.
在部分但并非所有研究中，抗磷脂抗体与缺血性卒中相关。
我们开展了一项基于人群的病例对照研究，利用存储的冷冻血清和血浆检测160例病例和340例对照中的抗磷脂抗体（抗心磷脂抗体和狼疮抗凝物），这些病例和对照均纳入了年轻女性卒中预防研究。我们通过酶联免疫吸附测定评估抗心磷脂抗体（IgG、IgM和IgA亚型）的存在情况，并使用多种依赖磷脂的凝血试验（活化部分凝血活酶时间、稀释蝰蛇毒时间）及混合试验评估狼疮抗凝物。如果混合试验结果延长，则进行确证试验。
43例病例（26.9%）和62例对照（18.2%）出现任何亚型的抗心磷脂抗体水平阳性（P=0.03）；29例病例（20.9%）和38例对照（12.8%）出现狼疮抗凝物阳性（P=0.03）；61例病例（42.1%）和86例对照（27.9%）出现抗心磷脂抗体或狼疮抗凝物阳性（P=0.003）。在对年龄、当前吸烟情况、高血压、糖尿病、心绞痛、种族、体重指数和高密度脂蛋白水平进行校正后，任何亚型抗心磷脂抗体免疫反应性或狼疮抗凝物阳性的女性发生卒中的相对比值为1.87（95%置信区间为1.24至2.83；P=0.0027）。
本研究结果支持抗磷脂抗体作为年轻女性卒中独立危险因素的重要性。
