Department of Internal Medicine, National Reference Centre for Systemic Sclerosis, University Hospital, Université Lille Nord de France, Lille, France.
Lupus. 2011 Jul;20(8):861-5. doi: 10.1177/0961203310397080. Epub 2011 May 5.
Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by arterial and/or venous thromboses and/or pregnancy-associated morbidity. Some patients develop only obstetric complications (obstetric APS), but data on the frequency of thrombotic events during the follow-up of these patients are scarce. This study was undertaken to evaluate the rate of thrombotic events after obstetric APS diagnosis according to the 2006 revised criteria. In total, 32 obstetric APS patients were retrospectively studied, with mean follow-up of 50 ± 37 months. After delivery, aspirin was prescribed to all patients as primary thrombosis prevention. The thrombosis rate was 3.3/100 patient-years and was 4.6, 4.5 and 10/100 patient-years when we considered at least two antiphospholipid antibody positivities (among lupus anticoagulant, anticardiolipin and anti-β2-glycoprotein-I), antinuclear antibody positivity or systemic lupus erythematosus-associated APS patients, respectively. The thrombosis rate was high after obstetric APS diagnosis, even for patients taking aspirin. Larger, prospective studies are needed to confirm this high frequency and determine the associated risk factors.
抗磷脂综合征(APS)是一种以动脉和/或静脉血栓形成和/或与妊娠相关的发病率为特征的系统性自身免疫性疾病。一些患者仅出现产科并发症(产科 APS),但关于这些患者随访期间血栓事件发生率的数据却很少。本研究旨在根据 2006 年修订的标准评估产科 APS 诊断后血栓事件的发生率。共回顾性研究了 32 例产科 APS 患者,平均随访 50±37 个月。产后,所有患者均接受阿司匹林作为一级血栓预防。血栓形成率为 3.3/100 患者年,当我们考虑至少两种抗磷脂抗体阳性(狼疮抗凝物、抗心磷脂抗体和抗β2-糖蛋白 I)、抗核抗体阳性或系统性红斑狼疮相关 APS 患者时,血栓形成率分别为 4.6、4.5 和 10/100 患者年。即使在服用阿司匹林的患者中,产科 APS 诊断后血栓形成率也很高。需要更大规模的前瞻性研究来证实这种高频率,并确定相关的危险因素。