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有和无血栓形成危险因素的抗磷脂综合征患者初级预防的有效性综述:疗效与安全性

Review on Effectiveness of Primary Prophylaxis in aPLs with and without Risk Factors for Thrombosis: Efficacy and Safety.

作者信息

Qushmaq Nahid A, Al-Emadi Samar A

机构信息

King Abdullah Medical Complex-Jeddah (KAMCJ), Al-Ameer Nayef Street, North Obhur, P.O. Box 55659, Jeddah 21544, Saudi Arabia.

Department of Medicine, Rheumatology Section, Hamad Medical Corporation, P.O. Box 3050, Off Al Rayyan Road, Opposite Lulu Center, Doha, Qatar.

出版信息

ISRN Rheumatol. 2014 Apr 17;2014:348726. doi: 10.1155/2014/348726. eCollection 2014.

Abstract

Context. Antiphospholipid antibodies syndrome is an autoimmune disorder that is characterized by the association between presence of antiphospholipid antibodies and risk of thrombosis and/or pregnancy morbidity. Objectives. To systematically review the evidence for primary prophylaxis in patients with antiphospholipids antibodies syndrome or APS with or without other traditional risk factors of thrombosis when they did not have any thrombotic event yet. Methods. PubMed, the Cochrane Library, and Allied Health Literature were searched for studies that examined the efficacy and safety of primary prophylaxis in aPL patients from 1990 to February 2013. We examined literature looking at patients with aPLs with other risk factors for thrombosis and aPLs with no additional risk factors for thrombosis. Conclusion. We concluded that, in patients with aPLs, primary prophylaxes with HCQ and aspirin have been observed to reduce the frequency of thrombotic events in the case of asymptomatic aPL-positive patients with SLE. We also in this study concluded that LDA was effective in patients with autoimmune diseases. Independent cardiovascular risk factors include autoimmune defects such as SLE, rheumatoid arthritis, and atherosclerosis, where overall venous thrombosis will be induced by systemic inflammation. This review concludes that HCQ is an effective primary approach when compared to aspirin.

摘要

背景。抗磷脂抗体综合征是一种自身免疫性疾病,其特征是抗磷脂抗体的存在与血栓形成风险和/或妊娠并发症之间存在关联。目的。系统评价在尚未发生任何血栓事件的抗磷脂抗体综合征(APS)患者(无论有无其他传统血栓形成危险因素)中进行一级预防的证据。方法。检索PubMed、Cochrane图书馆和联合健康文献数据库,查找1990年至2013年2月期间研究抗磷脂抗体(aPL)患者一级预防有效性和安全性的研究。我们研究了有其他血栓形成危险因素的aPL患者和无其他血栓形成危险因素的aPL患者的文献。结论。我们得出结论,在aPL患者中,对于无症状aPL阳性的系统性红斑狼疮(SLE)患者,观察到使用羟氯喹(HCQ)和阿司匹林进行一级预防可降低血栓形成事件的发生率。我们在本研究中还得出结论,低剂量阿司匹林(LDA)对自身免疫性疾病患者有效。独立的心血管危险因素包括自身免疫缺陷,如SLE、类风湿性关节炎和动脉粥样硬化,全身性炎症会诱发总体静脉血栓形成。本综述得出结论,与阿司匹林相比,HCQ是一种有效的一级预防方法。

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