Zoghlami-Rintelen C, Vormittag R, Sailer T, Lehr S, Quehenberger P, Rumpold H, Male C, Pabinger I
Division of Haematology and Blood Coagulation, Department of Internal Medicine I, Medical University Vienna, Vienna, Austria.
J Thromb Haemost. 2005 Jun;3(6):1160-5. doi: 10.1111/j.1538-7836.2005.01394.x.
Lupus anticoagulant (LA) is a strong risk factor of thrombosis. However, a subgroup of patients positive for LA is unaffected by thrombosis and currently no predictive markers are available to identify patients positive for LA at increased risk for thrombosis.
The aim of the study was to investigate whether anti-beta-2-glycoprotein I (anti-beta2GPI) or anticardiolipin antibodies (ACA) are associated with an increased risk of thrombosis in patients persistently positive for LA.
A cohort of 87 consecutive patients persistently positive for LA was investigated, 55 with and 32 without a history of thrombosis. Immunoglobulin G (IgG) and M (IgM) antibodies against beta2GPI and cardiolipin were determined by enzyme-linked immunoassay.
Patients positive for LA with thrombosis had significantly higher levels of anti-beta2GPI IgG (median 16.7 standard units, interquartile range 3.0-75.2, P = 0.002) and of ACA IgG (41.1 IgG phospholipid units per mL, 8.9-109.0, P = 0.002) than those without thrombosis (2.6, 1.4-7.9 and 9.7, 4.6-22.1, respectively). Levels of anti-beta2GPI IgM and ACA IgM did not differ significantly between LA patients with and without thrombosis (P = 0.25 and 0.12, respectively). Elevated anti-beta2GPI IgG was associated with an increased risk for thrombosis (OR = 4.0, 95% CI 1.2-13.1), especially for venous thromboembolism (OR = 5.2, 95% CI 1.5-18.0).
Increased levels of anti-beta2GPI IgG were associated with thrombosis. We conclude that anti-beta2GPI IgG levels above normal predict an increased risk of thrombosis in patients persistently positive for LA.
狼疮抗凝物（LA）是血栓形成的一个重要危险因素。然而，LA检测呈阳性的患者亚组中，有一部分患者并未发生血栓形成，目前尚无预测标志物可用于识别LA检测呈阳性且血栓形成风险增加的患者。
本研究旨在探讨抗β2糖蛋白I（抗β2GPI）或抗心磷脂抗体（ACA）是否与LA持续阳性患者的血栓形成风险增加相关。
对连续87例LA持续阳性患者进行了研究，其中55例有血栓形成病史，32例无血栓形成病史。采用酶联免疫吸附测定法检测抗β2GPI和抗心磷脂的免疫球蛋白G（IgG）和M（IgM）抗体。
有血栓形成的LA阳性患者的抗β2GPI IgG水平（中位数16.7标准单位，四分位间距3.0 - 75.2，P = 0.002）和ACA IgG水平（41.1 IgG磷脂单位/mL，8.9 - 109.0，P = 0.002）显著高于无血栓形成的患者（分别为2.6，1.4 - 7.9和9.7，4.6 - 22.1）。有血栓形成和无血栓形成的LA患者之间，抗β2GPI IgM和ACA IgM水平无显著差异（P分别为0.25和0.12）。抗β2GPI IgG升高与血栓形成风险增加相关（OR = 4.0，95%CI 1.2 - 13.1），尤其是静脉血栓栓塞（OR = 5.2，95%CI 1.5 - 18.0）。
抗β2GPI IgG水平升高与血栓形成相关。我们得出结论，高于正常水平的抗β2GPI IgG可预测LA持续阳性患者的血栓形成风险增加。
