Alijotas-Reig Jaume, Ferrer-Oliveras Raquel, Esteve-Valverde Enrique, Ruffatti Amelia, Tincani Angela, Lefkou Elmina, Bertero Maria Tiziana, Espinosa Gerard, Coloma Emmanuel, de Carolis Sara, Rovere-Querini Patrizia, Canti Valentina, Picardo Elisa, Fredi Micaela, Mekinian Arsene
Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Barcelona, Spain.
Department of Medicine, Universitat Autonoma, Barcelona, Spain.
Am J Reprod Immunol. 2016 Aug;76(2):164-71. doi: 10.1111/aji.12534.
To analyse the prevalence and effects of inherited thrombophilic disorders (ITD) on maternal-foetal outcomes in cases of antiphospholipid antibody related to obstetric complications.
Women with obstetric complaints who tested positive for aPL and with inherited thrombophilia were prospectively and retrospectively included.
ITD data were available in 208 of 338: 147 had obstetric antiphospholipid syndrome (OAPS) and 61 aPL-related obstetric morbidity (OMAPS). 24.1% had ITD. Laboratory categories I and IIa were more related to OAPS-ITD and IIb and IIc to OMAPS-ITD. No significant differences in obstetric complaints were observed. Regarding ITD carriers, treatment rates were higher in OAPS than in OMAPS for LMWH and LDA plus LMWH (P=.002).
Cases with aPL-related OAPS/OMAPS showed no differences in maternal-foetal outcomes regardless of the presence of one ITD. Maternal thrombotic risk was low, with ITD-positive cases included. Registry data concur with Sydney criteria, whereby aPL-ITD-positive patients are classified as having antiphospholipid syndrome.
分析遗传性血栓形成倾向疾病(ITD)在与产科并发症相关的抗磷脂抗体病例中对母婴结局的患病率及影响。
前瞻性和回顾性纳入有产科主诉且抗磷脂抗体(aPL)检测呈阳性并伴有遗传性血栓形成倾向的女性。
338例中有208例可获得ITD数据:147例患有产科抗磷脂综合征(OAPS),61例患有aPL相关的产科发病率(OMAPS)。24.1%的患者患有ITD。实验室分类I和IIa与OAPS-ITD的相关性更强,而IIb和IIc与OMAPS-ITD的相关性更强。在产科主诉方面未观察到显著差异。对于ITD携带者,OAPS中低分子肝素(LMWH)以及低剂量阿司匹林(LDA)加LMWH的治疗率高于OMAPS(P = 0.002)。
与aPL相关的OAPS/OMAPS病例,无论是否存在一种ITD,母婴结局均无差异。包括ITD阳性病例在内,孕产妇血栓形成风险较低。登记数据与悉尼标准一致,据此aPL-ITD阳性患者被归类为患有抗磷脂综合征。