Internal medicine, Bezanijska Kosa, University Medical Center, Belgrade, Serbia.
Lupus. 2012 Mar;21(3):338-45. doi: 10.1177/0961203311422710. Epub 2011 Oct 12.
Repeated thromboses are the most frequent clinical manifestation of antiphospholipid syndrome (APS) in the presence of antiphospholipid antibodies (aPL). The objective of this study was to observe the prevalence and localization of thrombosis, and to investigate the importance of aPL type and level for thrombosis-related events in patients diagnosed with APS. These are the first results of patients enrolled in Serbian National Cohort Study which comprises 256 patients: 162 with primary antiphospholipid syndrome (PAPS) and 94 with APS associated with systemic lupus erythematosus (SLE). aPL analysis included detection of aCL (IgG/IgM), β(2)GPI, and lupus anticoagulant. Thrombosis was diagnosed in 119 (46.5%) patients, with higher prevalence in PAPS compared with SLE patients (51.2% and 38.3%, respectively, p = 0.045). There was similar prevalence of arterial thrombosis in PAPS and SLE groups (34.6% and 34%, respectively, p = 0.932) although venous thrombosis was more frequent in PAPS (25.9% and 8.5%, respectively, p = 0.001). Thrombosis was observed in 92 (55.8%) patients who had more than one type of antibody (category I), in 13 (41.9%) patients with category IIa, in 19 (46.3%) patients with category IIb, and in 73 (44.2%) patients with category IIc (p = 0.10). The patients with thrombosis were older than those without thrombosis (49.8 and 39.8 years, respectively, p = 0.001). Overall, older age was a risk factor for thrombosis. The prevalence of venous thrombosis was higher in the PAPS group, but with lower frequency than in literature data. Any aPL type and level is a risk factor for thrombosis.
反复血栓形成是抗磷脂综合征（APS）患者存在抗磷脂抗体（aPL）时最常见的临床表现。本研究的目的是观察血栓形成的发生率和部位，并探讨aPL 类型和水平对诊断为 APS 患者血栓相关事件的重要性。这些是纳入塞尔维亚国家队列研究的患者的首批结果，该研究共纳入 256 例患者：162 例原发性抗磷脂综合征（PAPS）患者和 94 例系统性红斑狼疮（SLE）相关 APS 患者。aPL 分析包括检测 aCL（IgG/IgM）、β(2)GPI 和狼疮抗凝剂。119 例（46.5%）患者诊断为血栓形成，PAPS 患者的发生率高于 SLE 患者（分别为 51.2%和 38.3%，p=0.045）。PAPS 和 SLE 组的动脉血栓形成发生率相似（分别为 34.6%和 34%，p=0.932），尽管 PAPS 组的静脉血栓形成更为常见（分别为 25.9%和 8.5%，p=0.001）。92 例（55.8%）患者存在一种以上抗体（I 类）时观察到血栓形成，13 例（41.9%）患者为 IIa 类，19 例（46.3%）患者为 IIb 类，73 例（44.2%）患者为 IIc 类（p=0.10）。发生血栓形成的患者比未发生血栓形成的患者年龄更大（分别为 49.8 岁和 39.8 岁，p=0.001）。总体而言，年龄较大是血栓形成的危险因素。PAPS 组的静脉血栓形成发生率较高，但低于文献数据。任何 aPL 类型和水平都是血栓形成的危险因素。
