Department of Cardiac, Thoracic and Vascular Sciences, Clinical Cardiology, Thrombosis Centre, University of Padova Medical School, Padua, Italy.
Semin Thromb Hemost. 2012 Jun;38(4):322-7. doi: 10.1055/s-0032-1304719. Epub 2012 Mar 7.
Venous or arterial thrombosis or pregnancy morbidity in the presence of circulating antiphospholipid antibodies (aPL) define the antiphospholipid syndrome (APS). In terms of accepted APS criteria, aPL are detected by one coagulation test (lupus anticoagulant; LAC) and two immunoassays (anticardiolipin antibodies and anti-β2-glycoptrotein I antibodies). In patients with APS, a single positive test carries a much lower risk of thrombosis recurrence or new pregnancy loss than does multiple (or triple) positivity. The same holds true for aPL carriers, namely subjects with laboratory tests but without clinical criteria for APS. Thus, very different risk categories exist among patients with APS as well as in carriers of aPL. Triple positivity apparently identifies the pathogenic autoantibody (antidomain I-II of β2-glycoptrotein I); it is in this category of patients that trials on new therapeutic strategies should focus.
存在循环抗磷脂抗体 (aPL) 的静脉或动脉血栓形成或妊娠并发症定义为抗磷脂综合征 (APS)。根据公认的 APS 标准，通过一种凝血试验 (狼疮抗凝物；LAC) 和两种免疫测定法 (抗心磷脂抗体和抗-β2-糖蛋白 I 抗体) 检测 aPL。在 APS 患者中，单一阳性试验的血栓复发或新的妊娠丢失风险远低于多次 (或三重) 阳性。对于 aPL 携带者也是如此，即具有实验室检查但没有 APS 临床标准的受试者。因此，APS 患者以及 aPL 携带者存在非常不同的风险类别。三重阳性显然可识别致病性自身抗体 (β2-糖蛋白 I 的抗结构域 I-II)；应在这一患者类别中集中开展新治疗策略的试验。
