Zhang Shulan, Wu Ziyan, Li Jing, Li Ping, Chen Si, Wen Xiaoting, Li Liubing, Zhang Wen, Zhao Jiuliang, Zhang Fengchun, Li Yongzhe
Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuai Fu Yuan, Eastern District, Beijing, 100730, China.
Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Rheumatol Int. 2017 Apr;37(4):579-584. doi: 10.1007/s00296-016-3594-0. Epub 2016 Nov 2.
A hallmark feature of antiphospholipid syndrome (APS) is the presence of a wide spectrum of antiphospholipid antibodies. In this study, we evaluated the clinical relevance of antibodies to prothrombin (PT) (aPT) and thrombin (aThr) in Chinese patients with APS. A total of 229 subjects were tested, including 86 patients with APS [35 patients with primary APS (PAPS), 51 patients with APS associated with other diseases (APSAOD)], 104 patients with non-APS diseases (disease controls), and 39 healthy controls. Serum IgG/IgM/IgA aPT and aThr were determined by ELISA. The levels of both IgG/IgM/IgA aPT and IgG/IgM/IgA aThr were significantly increased in patients with PAPS and APSAOD compared with patients with non-APS thrombosis and non-APS PRM, and HC. Both IgG aPT and IgG aThr exhibited promising diagnostic potentials for APS with sensitivities and specificities of 16.3 and 95.8% (IgG aPT), and 19.8 and 99.3% (IgG aThr), respectively. Importantly, both IgG aPT (OR 4.06; 95% CI 1.49-11.05) and IgG aThr (OR 4.49; 95% CI 1.62-12.45) were significantly correlated with arterial, but not venous, thrombotic events. Our findings highlighted that IgG aPT and IgG aThr could serve as promising biomarkers to identify patients at risk of arterial thrombosis in China.
抗磷脂综合征（APS）的一个标志性特征是存在多种抗磷脂抗体。在本研究中，我们评估了中国APS患者中抗凝血酶原（PT）抗体（aPT）和抗凝血酶（aThr）抗体的临床相关性。共检测了229名受试者，包括86例APS患者[35例原发性APS（PAPS）患者，51例与其他疾病相关的APS（APSAOD）患者]，104例非APS疾病患者（疾病对照）和39名健康对照。通过酶联免疫吸附测定（ELISA）法测定血清IgG/IgM/IgA aPT和aThr。与非APS血栓形成患者、非APS原发性抗磷脂综合征（PRM）患者及健康对照相比，PAPS和APSAOD患者的IgG/IgM/IgA aPT和IgG/IgM/IgA aThr水平均显著升高。IgG aPT和IgG aThr对APS均具有良好的诊断潜力，敏感性和特异性分别为16.3%和95.8%（IgG aPT），以及19.8%和99.3%（IgG aThr）。重要的是，IgG aPT（比值比[OR] 4.06；95%置信区间[CI] 1.49 - 11.05）和IgG aThr（OR 4.49；95% CI 1.62 - 12.45）均与动脉血栓形成事件显著相关，而与静脉血栓形成事件无关。我们的研究结果表明，IgG aPT和IgG aThr可作为有前景的生物标志物，用于识别中国有动脉血栓形成风险的患者。
