Söhngen D, Specker C, Wehmeier A, Kiefel V, Rathmer L, Söhngen R, Schneider W
Abteilung Hämatologie, Onkologie und Klinische Immunologie (Med. Klinik A), Heinrich-Heine Universität, Düsseldorf, BRD.
Beitr Infusionsther. 1992;30:469-73.
Prevalence of lupus anticoagulant (LA) in patients with systemic lupus erythematosus (SLE) and clinical manifestations vary widely between different clinical series. We investigated the relation between LA, autoimmune hemolytic anemia (AIHA), thrombocytopenia and platelet dysfunction in 80 unselected patients with SLE. AIHA was found in 6 patients (7.5%) and thrombocytopenia in 10 patients (12.5%), which was not related to platelet aggregation abnormalities. Compared to controls, patients with SLE showed significantly prolonged aPTT and kaolin clotting time (KCT), but platelet aggregation induced by both collagen and thrombin was not impaired. LA activity as defined by Rosner et al. (index for LA/ICA) was found in 15 patients (18.9%). Only 7 of these patients showed a positive platelet neutralization test (Triplett) and 9a positive tissue thromboplastin inhibition test (Schleider). In our SLE patients 23.7% have suffered from at least one thrombotic complication. In patients with LA activity thromboembolic complications were increased (p < 0.05). Thrombocytopenia was found in 6% of LA-negative but in 20% of LA-positive patients.
系统性红斑狼疮（SLE）患者中狼疮抗凝物（LA）的患病率以及临床表现，在不同临床系列中差异很大。我们调查了80例未经挑选的SLE患者中LA、自身免疫性溶血性贫血（AIHA）、血小板减少症和血小板功能障碍之间的关系。6例患者（7.5%）发现有AIHA，10例患者（12.5%）有血小板减少症，这与血小板聚集异常无关。与对照组相比，SLE患者的活化部分凝血活酶时间（aPTT）和高岭土凝血时间（KCT）显著延长，但胶原和凝血酶诱导的血小板聚集未受损害。按照Rosner等人定义的LA活性（LA/ICA指数），在15例患者（18.9%）中检测到。这些患者中只有7例血小板中和试验（Triplett法）呈阳性，9例组织凝血活酶抑制试验（Schleider法）呈阳性。在我们的SLE患者中，23.7%至少发生过一次血栓形成并发症。有LA活性的患者血栓栓塞并发症增加（p<0.05）。在LA阴性患者中血小板减少症的发生率为6%，而在LA阳性患者中为20%。
