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[肾脏科医生应该了解哪些关于抗磷脂综合征的知识?]

[What the nephrologist should know about antiphospholipid syndrome?].

作者信息

Heleniak Zbigniew, Zdrojewski Zbigniew, Rutkowski Bolesław

机构信息

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Poland.

出版信息

Pol Merkur Lekarski. 2009 Mar;26(153):215-9.

Abstract

Antiphospholipid syndrome is often recognize autoimmune disease associated with arterial and venous thrombosis and pregnancy loss. It is caused by antibodies against proteins combined with cell membrane anionic phospholipids. Kidney are one of the most often affected organs in course of antiphospholipid syndrome. Renal manifestations include thrombotic microangiopathy and large vessel thrombosis. In patients with end-stage renal disease, antiphospholipid antibodies are prevalent and may increase in frequency with time on dialysis. The presence of anticardiolipin antibodies have been associated with high incidence of hemodialysis access clotting. In renal transplant recipients, the incidence of antiphospholipid antibodies is also elevated and may be associated with higher incidence of primary graft non-function. Treatment of antiphospholipid syndrome remains centered around anticoagulation. The use of immunosuppressive agents could be very useful. Early detection of renal involvement and treatment may improve the prognosis of these patients.

摘要

抗磷脂综合征通常被认为是一种与动脉和静脉血栓形成以及流产相关的自身免疫性疾病。它是由针对与细胞膜阴离子磷脂结合的蛋白质的抗体引起的。肾脏是抗磷脂综合征病程中最常受累的器官之一。肾脏表现包括血栓性微血管病和大血管血栓形成。在终末期肾病患者中,抗磷脂抗体很常见,并且可能随着透析时间的延长而增加频率。抗心磷脂抗体的存在与血液透析通路凝血的高发生率相关。在肾移植受者中,抗磷脂抗体的发生率也升高,并且可能与原发性移植无功能的较高发生率相关。抗磷脂综合征的治疗仍然以抗凝为核心。免疫抑制剂的使用可能非常有用。早期发现肾脏受累并进行治疗可能会改善这些患者的预后。

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