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[抗磷脂综合征]

[Antiphospholipid syndrome].

作者信息

Specker C

机构信息

Klinik für Rheumatologie & Klinische Immunologie, Katholisches Krankenhaus St. Josef, Zentrum für Innere Medizin der Kliniken Essen Süd, Essen.

出版信息

Z Rheumatol. 2007 Feb;66(1):41-50; quiz 51-2. doi: 10.1007/s00393-006-0127-3.

Abstract

Antiphospholipid syndrome (APS) is characterized by recurrent arterial or venous thromboembolism or pregnancy loss in association with antibodies directed against anionic phospholipids or plasma proteins bound to anionic phospholipids. A common cause of the huge variety of clinical manifestations is vaso-occlusive disease and not vasculitis in venous or arterial blood vessels of different sizes and sites (i.e. deep vein thrombosis, pulmonary embolism, cerebrovascular disease). In accordance with this, fetal abortion, typically beyond the tenth week of gestation, is also caused by infarctions of blood vessels in the placenta. Establishing the correct diagnosis of APS is not easy. To estimate the risk of thrombotic complications is challenging, as well as the questions of, which, how long and in what strength anticoagulation is recommended. This paper should enable the reader to apply international consensus classification criteria correctly, to interpret the different laboratory tests for anti-phospholipid antibodies and to gain an awareness of the different forms of anticoagulation in order to stratify therapeutic decisions.

摘要

抗磷脂综合征(APS)的特征是反复出现动脉或静脉血栓栓塞或妊娠丢失,并伴有针对阴离子磷脂或与阴离子磷脂结合的血浆蛋白的抗体。多种临床表现的常见原因是血管闭塞性疾病,而非不同大小和部位的静脉或动脉血管的血管炎(即深静脉血栓形成、肺栓塞、脑血管疾病)。据此,典型的妊娠10周后流产也是由胎盘血管梗死引起的。正确诊断APS并不容易。估计血栓形成并发症的风险具有挑战性,推荐何种抗凝治疗、抗凝时长及强度等问题也颇具挑战。本文应能使读者正确应用国际共识分类标准,解读抗磷脂抗体的不同实验室检测方法,并了解不同形式的抗凝治疗,从而对治疗决策进行分层。

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