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他汀类药物对系统性红斑狼疮合并抗磷脂抗体患者血栓形成的影响。

Effects of statins on thrombosis development in patients with systemic lupus erythematosus and antiphospholipid antibodies.

作者信息

Watanabe T, Oku K, Amengual O, Hisada R, Ohmura K, Nakagawa I, Shida H, Bohgaki T, Horita T, Yasuda S, Atsumi T

机构信息

Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

出版信息

Lupus. 2018 Feb;27(2):225-234. doi: 10.1177/0961203317716787. Epub 2017 Jun 28.

DOI:10.1177/0961203317716787
PMID:28659045
Abstract

The objective of this study is to identify the effects of statins and risk factors for thrombosis in patients with new onset of systemic lupus erythematosus (SLE) with or without antiphospholipid antibodies (aPL). Consecutive patients with SLE without history of thrombotic events were retrospectively enrolled from April 1997 to February 2014. The development of first thrombosis and death caused by thrombosis were defined as the study endpoint. Risk and protective factors for developing thrombosis were analyzed. A total of 152 patients, 80 positive and 72 negative for aPL, were included. In aPL-positive patients, 15 developed arterial ( n = 6) and venous ( n = 9) thrombosis (median follow-up period 69 months). Cox's proportional hazards model showed that older age at SLE onset and IgG-anticardiolipin antibodies (aCL) were statistically significant risks for thrombosis. Statin therapy was identified as a statistically significant protective factor against thrombosis (hazard ratio 0.12, 95% confidence interval 0.01-0.98). In aPL-negative patients (median follow-up period 46 months), seven patients developed thrombosis (five arterial and two venous). No risk factors for thrombosis were found in this group. In aPL-positive patients with SLE, the late disease onset and the presence of IgG-aCL represented additional risk factors for thrombosis. Statin treatment appeared as a protective factor for thrombosis.

摘要

本研究的目的是确定他汀类药物对新发性系统性红斑狼疮(SLE)伴或不伴抗磷脂抗体(aPL)患者血栓形成的影响及血栓形成的危险因素。1997年4月至2014年2月,对无血栓形成事件病史的连续性SLE患者进行回顾性纳入研究。首次血栓形成的发生及由血栓形成导致的死亡被定义为研究终点。分析了发生血栓形成的风险和保护因素。共纳入152例患者,其中aPL阳性80例,aPL阴性72例。在aPL阳性患者中,15例发生动脉(n = 6)和静脉(n = 9)血栓形成(中位随访期69个月)。Cox比例风险模型显示,SLE发病时年龄较大和IgG-抗心磷脂抗体(aCL)是血栓形成的统计学显著风险因素。他汀类药物治疗被确定为预防血栓形成的统计学显著保护因素(风险比0.12,95%置信区间0.01 - 0.98)。在aPL阴性患者中(中位随访期46个月),7例患者发生血栓形成(5例动脉血栓和2例静脉血栓)。该组未发现血栓形成的危险因素。在伴有SLE的aPL阳性患者中,疾病晚期发病和IgG-aCL的存在是血栓形成的额外风险因素。他汀类药物治疗似乎是血栓形成的保护因素。

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