Marlar Richard A, Husain Sanam
Laboratory Services #113, Oklahoma City Veterans Administration Medical Center, 921 Northeast 13th Street, Oklahoma City, OK 73104, USA.
Curr Rheumatol Rep. 2008 Jan;10(1):74-80. doi: 10.1007/s11926-008-0013-x.
Lupus anticoagulant (LA) is a laboratory abnormality associated with the antiphospholipid syndrome. It is a paradoxical phenomenon in which one or more in vitro diagnostic clotting tests are prolonged and thus seem due to an anticoagulant, whereas the antiphospholipid syndrome is manifest clinically as inappropriate or excessive thrombosis. LA should be suspected when thrombosis, recurrent fetal loss, or a prolonged phospholipid (PL)-dependent clotting test is present without other identifiable causes. Despite the heterogeneity of LA antibodies, a consensus has evolved to identify the LA. Four conditions must be met for this laboratory diagnosis: 1) prolongation of a PL-based clotting test, 2) confirmation of an inhibitor-like pattern in the clotting test, 3) confirmation of PL dependence in coagulation tests, and 4) exclusion of a specific factor inhibitor. Even with an extensive armamentarium for LA diagnosis and treatment, it is still a formidable task.
狼疮抗凝物（LA）是一种与抗磷脂综合征相关的实验室异常。这是一种自相矛盾的现象，即一项或多项体外诊断性凝血试验延长，因此似乎是由抗凝物导致的，而抗磷脂综合征在临床上表现为不适当或过度的血栓形成。当出现血栓形成、反复流产或磷脂（PL）依赖性凝血试验延长且无其他可识别原因时，应怀疑存在LA。尽管LA抗体具有异质性，但已形成了识别LA的共识。进行该实验室诊断必须满足四个条件：1）基于PL的凝血试验延长；2）在凝血试验中确认类似抑制剂的模式；3）在凝血试验中确认PL依赖性；4）排除特定因子抑制剂。即使有大量用于LA诊断和治疗的手段，这仍然是一项艰巨的任务。
