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[狼疮抗凝物]

[Lupus anticoagulant].

作者信息

Yoshida A, Morozumi K

机构信息

Division of Nephrology, Nagoya Daini Red Cross Hospital.

出版信息

Rinsho Byori. 1992 Oct;40(10):1007-13.

PMID:1307602
Abstract

Lupus anticoagulant (LAC) is an acquired inhibitor of prothrombin activator complex, which probably interferes with the phospholipid portion. Characteristically, LAC prolongs the partial prothrombin time, but only slightly prolongs the prothrombin time. It is a paradoxical fact that LAC is characterized by thrombosis. It was initially described in patients with SLE, but recently, it has been described as occurring with other autoimmune disorders. Patients with LAC have been treated with steroid and aspirin, anti platelet agents or warfarin. Steroid and aspirin therapy has been reported useful for habitual abortion associated with LAC. In our study, 11 patients, whose prior pregnancies resulted in habitual abortion (41 abortions), received intentional prednisolone (40 mg/day) and aspirin (81 mg/day) therapy before further pregnancies. The doses of both agents were decreased gradually, and the therapy with prednisolone (10-15 mg/day) and aspirin (40.5 mg/day) was maintained during the pregnancy period. The outcome of pregnancy was successful in 7 out of 10 pregnancies. To evaluate the relationship between LAC and glomerulopathy, we examined the renal biopsy from 5 LAC cases without SLE. In pathological findings, there were 3 of with mild proliferative GN and 2 cases of minor glomerular abnormality. There were no characteristic findings in LAC nephropathy.

摘要

狼疮抗凝物(LAC)是一种获得性凝血酶原激活物复合物抑制剂,可能干扰磷脂部分。其特点是LAC会延长部分凝血活酶时间,但仅轻微延长凝血酶原时间。一个矛盾的事实是,LAC的特征是血栓形成。它最初在系统性红斑狼疮(SLE)患者中被描述,但最近,也有报道称其与其他自身免疫性疾病有关。LAC患者已接受类固醇、阿司匹林、抗血小板药物或华法林治疗。据报道,类固醇和阿司匹林疗法对与LAC相关的习惯性流产有效。在我们的研究中,11例既往妊娠导致习惯性流产(共41次流产)的患者在再次怀孕前接受了泼尼松龙(40毫克/天)和阿司匹林(81毫克/天)的治疗。两种药物的剂量逐渐减少,在孕期维持泼尼松龙(10 - 15毫克/天)和阿司匹林(40.5毫克/天)的治疗。10次怀孕中有7次妊娠结局成功。为了评估LAC与肾小球病之间的关系,我们检查了5例无SLE的LAC患者的肾活检。病理检查结果显示,3例为轻度增生性肾小球肾炎(GN),2例为轻度肾小球异常。LAC肾病没有特征性表现。

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[Lupus anticoagulant].[狼疮抗凝物]
Rinsho Byori. 1992 Oct;40(10):1007-13.

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