Giannakopoulos Bill, Passam Freda, Ioannou Yiannis, Krilis Steven A
Department of Medicine, Immunology, Allergy and Infectious Diseases, University of New South Wales, St George Hospital, Kogarah, Australia.
Blood. 2009 Jan 29;113(5):985-94. doi: 10.1182/blood-2007-12-129627. Epub 2008 Aug 28.
The antiphospholipid syndrome (APS) is an acquired thrombophilia, characterized by the occurrence of venous and arterial events. This article examines the laboratory and key clinical aspects of APS. Particular focus is given to anti-beta 2-glycoprotein I (beta(2)GPI) antibodies in view of their recent inclusion in the APS classification criteria. The clinical utility of using the beta(2)GPI enzyme-linked immunosorbent assay, in conjunction with the established lupus anticoagulant assays and cardiolipin enzyme-linked immunosorbent assay, for diagnosing and risk stratifying patients suspected of having APS is discussed. The relative importance of the various assays in diagnosing obstetric APS (early and late gestation miscarriages) is explored. The implications of recent epidemiologic findings for possibly understanding the underlying pathophysiologic mechanisms of obstetric APS are highlighted. Insights into which patients with obstetric APS may be at most risk of thrombotic complications are presented.
抗磷脂综合征（APS）是一种获得性易栓症，其特征为发生静脉和动脉事件。本文探讨了APS的实验室检查及关键临床方面。鉴于抗β2糖蛋白I（β2GPI）抗体最近被纳入APS分类标准，故对其予以特别关注。本文讨论了使用β2GPI酶联免疫吸附测定法，结合已确立的狼疮抗凝物测定法和心磷脂酶联免疫吸附测定法，对疑似患有APS的患者进行诊断和风险分层的临床实用性。探讨了各种检测方法在诊断产科APS（孕早期和孕晚期流产）中的相对重要性。强调了近期流行病学研究结果对理解产科APS潜在病理生理机制的可能意义。介绍了对哪些产科APS患者血栓形成并发症风险最高的见解。
