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[抗磷脂抗体的临床特征]

[Clinical characteristics of anti-phospholipid antibodies].

作者信息

Shimmyozu K, Okadome T, Maruyama Y, Kadokura N, Maruyama I, Osame M, Tara M

机构信息

Third Department of Internal Medicine, Kagoshima University, School of Medicine, Japan.

出版信息

Rinsho Ketsueki. 1990 May;31(5):633-8.

PMID:2118574
Abstract

Twenty-one patients with anti-phospholipid antibodies (APLA), who were selected from 104 patients with antinuclear antibody or anti-DNA antibody, were studied to define clinical characteristics of APLA. Of the 21 patients, the incidences of IgG anti-cardiolipin antibody (ACA), IgM ACA, lupus anticoagulant (LAC) and BFP-STS were 20, 7, 11 and 12, respectively, and they were highly related with each other. The number of items of the 1982 ARA revised criteria for the classification of SLE was significantly low (mean value = 3.3), and also the level of serum C 4 was significantly high (mean value = 88% of normal) compared with those in patients without APLA. The incidence of thrombocytopenia and hemolysis was significantly high when compared with those in patients without APLA, and they were closely related to the presence of LAC. The incidence of thrombosis was markedly high (48%), 10 of 21 patients, especially those of cerebral infarction and deep vein thrombosis. Cerebral infarction was significantly associated with LAC. The obstetric complication was 4 of 13 patients (31%) in the incidence, which was significantly high compared with that in patients without APLA. Of them, natural abortion was closely associated with LAC. Based on these observations, it seems that autoimmunological disease activity in patients with APLA may be slight to mild, and strongly suggested that APLA may play an important role particularly in the pathogenesis of acquired thrombotic tendency.

摘要

从104例抗核抗体或抗DNA抗体患者中选出21例抗磷脂抗体(APLA)患者,研究APLA的临床特征。在这21例患者中,IgG抗心磷脂抗体(ACA)、IgM ACA、狼疮抗凝物(LAC)和BFP - STS的发生率分别为20例、7例、11例和12例,且它们之间高度相关。与无APLA的患者相比,1982年美国风湿病学会(ARA)修订的系统性红斑狼疮(SLE)分类标准的项目数显著较低(平均值 = 3.3),血清C4水平也显著较高(平均值 = 正常水平的88%)。与无APLA的患者相比,血小板减少症和溶血的发生率显著较高,且它们与LAC的存在密切相关。血栓形成的发生率显著较高(48%),21例患者中有10例,尤其是脑梗死和深静脉血栓形成。脑梗死与LAC显著相关。产科并发症在13例患者中的发生率为4例(31%),与无APLA的患者相比显著较高。其中,自然流产与LAC密切相关。基于这些观察结果,APLA患者的自身免疫性疾病活动可能为轻度至中度,强烈提示APLA可能尤其在获得性血栓形成倾向的发病机制中起重要作用。

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