Cucurull Elena, Gharavi Azzudin E., Menon Yamini, Wilson Wendell A.
*Department of Medicine, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310-1495, USA.
Curr Treat Options Cardiovasc Med. 2003 Apr;5(2):127-136. doi: 10.1007/s11936-003-0021-0.
Antiphospholipid antibody syndrome (APS) is a recently defined autoimmune disorder characterized by recurrent vascular thromboses or recurrent pregnancy morbidity; these features are linked to the presence in blood of autoantibodies against negatively charged phospholipids or phospholipid-binding proteins. Thrombosis can occur in any tissue, in veins, arteries, or the microvasculature. Pregnancy morbidity in APS includes miscarriages or premature birth. Criteria that define the major clinical and laboratory features of APS were published in 1999. In patients with antiphospholipid antibodies and prior thrombosis or pregnancy morbidity, there is a high risk of recurrence that persists as long as antiphospholipid antibodies occur in blood. This risk for recurrence of thrombosis or pregnancy morbidity is greatly reduced by preventive anticoagulant therapy. Patients presenting with thrombosis in APS are initially managed in much the same way as are patients with vascular thrombosis owing to other causes. However, in patients with APS, high-intensity anticoagulation is usually needed to prevent recurrences of thrombosis. Thrombosis in APS is often multifactorial, as with non-APS thrombosis. Therefore, in all patients with APS, other reversible risk factors for thrombosis should be sought. The pregnancy outcome of women with APS who have had prior miscarriages is greatly improved by treatment during pregnancy with a combination of heparin and low-dose aspirin.
抗磷脂抗体综合征（APS）是一种最近定义的自身免疫性疾病，其特征为反复出现血管血栓形成或反复发生妊娠并发症；这些特征与血液中存在针对带负电荷磷脂或磷脂结合蛋白的自身抗体有关。血栓可发生于任何组织，包括静脉、动脉或微血管。APS中的妊娠并发症包括流产或早产。定义APS主要临床和实验室特征的标准于1999年公布。对于有抗磷脂抗体且既往有血栓形成或妊娠并发症的患者，只要血液中存在抗磷脂抗体，复发风险就很高。预防性抗凝治疗可大大降低血栓形成或妊娠并发症复发的风险。APS患者出现血栓形成时，最初的处理方式与其他原因导致血管血栓形成的患者大致相同。然而，对于APS患者，通常需要强化抗凝以预防血栓复发。与非APS血栓形成一样，APS中的血栓形成通常是多因素的。因此，对于所有APS患者，都应寻找其他可逆的血栓形成危险因素。对于既往有流产史的APS女性患者，孕期联合使用肝素和小剂量阿司匹林进行治疗可大大改善妊娠结局。
