Saponjski Jovica, Stojanovich Ljudmila, Petrovic Jelena, Saponjski Dusan
Institute for Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia.
Internal Medicine, "Bezanijska Kosa", University Medical Center, Belgrade, Serbia.
Immunol Res. 2017 Apr;65(2):482-486. doi: 10.1007/s12026-016-8887-6.
Antiphospholipid syndrome (APS) is an autoimmune disease which is characterized by arterial and venous thromboses, fetal loss, and the presence of antiphospholipid antibodies in the serum. It is characterized by accelerated atherosclerosis. Increased tendency towards thrombosis leads to the occurrence of various vascular events. The objective of our study was to determine if there are subclinical changes on lower limb arteries in APS patients and what the best diagnostic choice for their establishment is. In this study, we analyzed 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients, who have secondary antiphospholipid syndrome (SAPS). The results were compared to 50 controls. The groups were comparable with respect to age, gender, and traditional risk factors except for the lipid status, since controls had significantly higher levels of cholesterol and triglycerides. Study was conducted on 64-multi-slice computed tomography (64-MSCT), where we analyzed quantitative and morphological characteristics of blood vessel-detected lesions. Patients from the control group had statistically very significant elevated cholesterol and triglyceride levels in regard to the patients with SAPS and PAPS (p < 0.001 and p < 0.05). Analyzing percentage of diameter stenosis, we have established that lesions from group with 0-30% diameter stenosis (DS) in patients with PAPS (n = 47) and SAPS (n = 39) are more common than that in control group (n = 3, p < 0.001). The incidence of lesions higher than 70% DS in control group (n = 74) was statistically significant than that in patients with SAPS (n = 74, p < 0.05), while very statistically significant than that in patients with PAPS (n = 48, p < 0.001). Analyzing the qualitative characteristics of plaques, we have established significant higher frequency of soft tissue (n = 32) and mixed lesions (n = 36) in patients with PAPS than the calcified one (n = 7, p < 0.001). Our study showed that the subclinical manifestation of changes on lower extremity arteries is more common in patients with APS. Because of its safety and accuracy, the method of choice is 64-MSCT angiography in monitoring disease progression.
抗磷脂综合征（APS）是一种自身免疫性疾病，其特征为动脉和静脉血栓形成、胎儿丢失以及血清中存在抗磷脂抗体。它的特点是动脉粥样硬化加速。血栓形成倾向增加会导致各种血管事件的发生。我们研究的目的是确定APS患者下肢动脉是否存在亚临床变化以及确立这些变化的最佳诊断选择是什么。在本研究中，我们分析了50例原发性抗磷脂综合征（PAPS）患者和50例继发性抗磷脂综合征（SAPS）患者。将结果与50例对照者进行比较。除血脂状况外，这些组在年龄、性别和传统危险因素方面具有可比性，因为对照者的胆固醇和甘油三酯水平显著更高。研究采用64排多层计算机断层扫描（64-MSCT）进行，我们分析了检测到的血管病变的定量和形态学特征。与SAPS和PAPS患者相比，对照组患者的胆固醇和甘油三酯水平在统计学上显著升高（p < 0.001和p < 0.05）。通过分析直径狭窄百分比，我们发现PAPS患者（n = 47）和SAPS患者（n = 39）中直径狭窄0 - 30%（DS）组的病变比对照组（n = 3，p < 0.001）更常见。对照组（n = 74）中直径狭窄高于70% DS的病变发生率在统计学上显著高于SAPS患者（n = 74，p < 0.05），而极显著高于PAPS患者（n = 48，p < 0.001）。通过分析斑块的定性特征，我们发现PAPS患者中软组织（n = 32）和混合性病变（n = 36）出现的频率显著高于钙化性病变（n = 7，p < 0.001）。我们的研究表明，下肢动脉变化的亚临床表现在APS患者中更为常见。由于其安全性和准确性，在监测疾病进展时的首选方法是64-MSCT血管造影。
