Belfeki N, Khanfir M S, Said F, Houman M H
Service de médecine interne, CHU la Rabta de Tunis, rue Jbel Lakhdar,La Rabta Jebbari, 1007 Tunis, Tunisie.
Service de médecine interne, CHU la Rabta de Tunis, rue Jbel Lakhdar,La Rabta Jebbari, 1007 Tunis, Tunisie.
J Med Vasc. 2018 Dec;43(6):347-353. doi: 10.1016/j.jdmv.2018.09.001. Epub 2018 Oct 31.
To investigate the thrombotic tendency in patients with systemic lupus erythematosus (SLE) by evaluating congenital and acquired abnormalities with an increased risk of thrombosis.
A total of 53 patients with SLE were included in the study. Fifty-three healthy controls paired by age and sex were assessed. Anticardiolipin antibodies (aCL), anti β2 glycoprotein (aβ2GP), lupus anticoagulant (LAC), protein C (PC), protein S (PS), antithrombin (AT), acquired activated protein C, and homocysteinemia were evaluated. Comparisons for categorical variables were analyzed by Chi and student tests.
The patients were all female and had a mean age of 30.6 years (16/58). The healthy controls were all female and their mean age was 30.8 years (17/56). Five patients (9.4%) developed venous thrombosis during the 24 months of follow-up. The antiphospholipid antibodies were positive in 17 patients (32.1%) and negative in all healthy controls (P=0.01). PS deficiency was noted in 17 patients (32.1%) and in 5 controls (P=0.004). Hyperhomocysteinemia was noted in 16 patients (30.2%) versus 3 controls (5.6%) (P=0.002). Test for PC deficiency and acquired activated protein C showed no significant difference between the two groups. No AT deficiency was found in the patients. The study of clinical and biological correlations based on the presence and absence of thrombophilic parameters concluded to a significant association between Protein C deficit and thrombosis (P=0.02) and acquired activated protein C resistance and thrombosis (P=0.04). There was no significant association between the APL and thrombosis.
Thrombophilic abnormalities were significantly more frequent in lupus patients than in healthy controls. Thrombotic events were significantly associated with PC deficit and acquired protein C resistance. There was no correlation between antiphospholipid antibodies and thrombosis.
通过评估先天性和获得性异常导致的血栓形成风险增加，来研究系统性红斑狼疮（SLE）患者的血栓形成倾向。
本研究共纳入53例SLE患者。评估了53例年龄和性别匹配的健康对照者。检测了抗心磷脂抗体（aCL）、抗β2糖蛋白（aβ2GP）、狼疮抗凝物（LAC）、蛋白C（PC）、蛋白S（PS）、抗凝血酶（AT）、获得性活化蛋白C和高同型半胱氨酸血症。分类变量的比较采用卡方检验和学生检验进行分析。
患者均为女性，平均年龄30.6岁（16/58）。健康对照者均为女性，平均年龄30.8岁（17/56）。5例患者（9.4%）在24个月的随访期间发生静脉血栓形成。17例患者（32.1%）抗磷脂抗体呈阳性，所有健康对照者均为阴性（P=0.01）。17例患者（32.1%）和5例对照者（P=0.004）存在PS缺乏。16例患者（30.2%）出现高同型半胱氨酸血症，而对照者为3例（5.6%）（P=0.002）。两组间PC缺乏和获得性活化蛋白C检测无显著差异。患者中未发现AT缺乏。基于是否存在血栓形成倾向参数进行的临床和生物学相关性研究得出，蛋白C缺乏与血栓形成之间存在显著关联（P=0.02），获得性活化蛋白C抵抗与血栓形成之间存在显著关联（P=0.04）。APL与血栓形成之间无显著关联。
狼疮患者血栓形成倾向异常的发生率显著高于健康对照者。血栓形成事件与PC缺乏和获得性蛋白C抵抗显著相关。抗磷脂抗体与血栓形成之间无相关性。
