Department of Hematology Oslo University Hospital Ullevål, Oslo, Norway.
Thromb Res. 2010 May;125(5):e222-7. doi: 10.1016/j.thromres.2009.12.006. Epub 2010 Jan 6.
In this population-based case-control study we explored the association of antiphospholipid antibodies with pregnancy-related venous thrombosis. From 1990 through 2003 615 pregnant women were identified at 18 hospitals in Norway with a diagnosis of first time VT. In 2006, 531 of 559 eligible cases and 1092 of 1229 eligible controls were invited for further investigations. The final study population comprised 313 cases and 353 controls, who completed a comprehensive questionnaire and donated a single blood sample, 3-16 years after index pregnancy. We report the results on lupus anticoagulant, anticardiolipin antibodies, and anti-ss(2) glycoprotein-1 antibodies alone, in combination, and with the contribution of the factor V Leiden and the prothrombin gene G20210A polymorphisms. Cut-off values for APAs were chosen according to current international consensus. 29 (9.3%) of the cases and 24 (6.8%) of the controls had at least one positive test for APAs (OR 1.4; 95% CI 0.8-2.5). Nine cases (2.8%) and no controls had more than one positive test (multi-positivity) for APAs. After excluding women with factor V Leiden or prothrombin polymorphisms, still 6 cases were multi-positive for APAs. We conclude that multi-positivity, but not single-positivity, for APAs was weakly associated with a history of ante- and postnatal VT.
在这项基于人群的病例对照研究中,我们探讨了抗磷脂抗体与妊娠相关静脉血栓形成的关系。1990 年至 2003 年期间,在挪威的 18 家医院中确定了 615 名首次诊断为 VT 的孕妇。2006 年,对 559 名符合条件的病例中的 531 名和 1229 名符合条件的对照中的 1092 名进行了进一步调查。最终的研究人群包括 313 例病例和 353 例对照,他们在妊娠后 3-16 年内完成了一份综合问卷并捐献了一份血样。我们报告了狼疮抗凝剂、抗心磷脂抗体和抗 ss(2)糖蛋白-1 抗体单独、联合以及与因子 V 莱顿和凝血酶原基因 G20210A 多态性的贡献的结果。根据当前的国际共识选择了 APA 的临界值。29 例(9.3%)病例和 24 例(6.8%)对照至少有一种 APA 检测结果阳性(OR 1.4;95%CI 0.8-2.5)。9 例(2.8%)病例和无对照有超过一种 APA 检测结果阳性(多阳性)。在排除因子 V 莱顿或凝血酶原多态性的妇女后,仍有 6 例病例对 APA 呈多阳性。我们的结论是,APA 的多阳性而不是单阳性与产前和产后 VT 的病史弱相关。