抗 annexin A5 抗凝活性与产科抗磷脂综合征病史的女性。
Resistance to annexin A5 anticoagulant activity in women with histories for obstetric antiphospholipid syndrome.
机构信息
Department of Hematology, Guy's and St Thomas's Trust, King's College, London, UK.
出版信息
Am J Obstet Gynecol. 2011 Nov;205(5):485.e17-23. doi: 10.1016/j.ajog.2011.06.019. Epub 2011 Jun 15.
OBJECTIVE
The objective of the study was to investigate whether resistance to annexin A5 anticoagulant activity (AnxA5) occurs in women with histories for obstetric complications of antiphospholipid syndrome (Obs-APS) and whether this correlates with antibody recognition of domain 1 of β2-glycoprotein.
STUDY DESIGN
One hundred thirty-six women with antiphospholipid antibodies, including 70 with histories for Obs-APS and 30 controls, were investigated.
RESULTS
Women with Obs-APS showed resistance to AnxA5 activity (median, 216%; range, 130-282% vs controls; median, 247%; range, 217-283%; P < .0001) and elevated levels of anti-domain I immunoglobulin (Ig) G (optical density: median, 0.056; range, 0.021-0.489 vs median, 0.042; range, 0.020-0.323; P = .002). Those in the lowest tertile of AnxA5 anticoagulant ratios had an odds ratio for Obs-APS of 58.0 (95% confidence interval, 3.3-1021.5). There was an inverse correlation between levels of annexin A5 anticoagulant activity and anti-domain I IgG.
CONCLUSION
Resistance to AnxA5 anticoagulant activity is associated with antibody recognition of domain I of β2-glycoprotein I and identifies a subset of women with histories for Obs-APS.
目的
本研究旨在探讨产科抗磷脂综合征（Obs-APS）病史的女性是否存在抗 annexin A5 抗凝活性（AnxA5）的耐药性，以及这种耐药性是否与β2-糖蛋白 I 结构域 1 的抗体识别相关。
研究设计
研究共纳入 136 名抗磷脂抗体阳性的女性，其中 70 名有 Obs-APS 病史，30 名作为对照组。
结果
Obs-APS 女性表现出对 AnxA5 活性的耐药性（中位数为 216%，范围为 130-282%；对照组中位数为 247%，范围为 217-283%；P<.0001），且抗结构域 I IgG 水平升高（光密度中位数：0.056，范围：0.021-0.489；对照组中位数：0.042，范围：0.020-0.323；P=.002）。AnxA5 抗凝比值最低三分位数的女性发生 Obs-APS 的优势比为 58.0（95%置信区间：3.3-1021.5）。AnxA5 抗凝活性水平与抗结构域 I IgG 呈负相关。
结论
AnxA5 抗凝活性的耐药性与β2-糖蛋白 I 结构域 1 的抗体识别有关，并可识别出具有 Obs-APS 病史的女性亚群。
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