Li G C, Greenberg C S, Currie M S
Department of Medicine, Duke University Medical Center, Durham, NC.
South Med J. 1988 Feb;81(2):262-4. doi: 10.1097/00007611-198802000-00029.
The specific factors predisposing to thrombosis in patients with LAs have not been resolved. With extensive cross-reactivity, and several proposed sites of action, LAs and their effects may be heterogeneous. While the risk of thrombosis with phenothiazine-induced LAs is probably low, the incidence of thrombosis in association with procainamide-induced LAs is uncertain. Procainamide is a commonly used antiarrhythmic drug associated with the induction of autoantibodies, and occasionally with a lupus-like syndrome. Serologic and coagulation profile monitoring may be required to detect patients in whom LAs develop since these individuals may be at increased risk for thrombosis. Monitoring may be especially important in patients who are receiving procainamide and who have atherosclerosis and cardiac disease, since they may be at increased risk for thrombosis of coronary and other arteries. Future prospective studies are needed to investigate whether the development of lupus anticoagulants during procainamide therapy increases the risk of thrombosis.
狼疮抗凝物（LA）患者易发生血栓形成的具体因素尚未明确。由于存在广泛的交叉反应以及多个提出的作用位点，LA及其效应可能具有异质性。虽然吩噻嗪诱导的LA导致血栓形成的风险可能较低，但与普鲁卡因胺诱导的LA相关的血栓形成发生率尚不确定。普鲁卡因胺是一种常用的抗心律失常药物，与自身抗体的诱导有关，偶尔还会引起狼疮样综合征。可能需要进行血清学和凝血指标监测以检测出发生LA的患者，因为这些个体发生血栓形成的风险可能增加。监测对于正在接受普鲁卡因胺治疗且患有动脉粥样硬化和心脏病的患者可能尤为重要，因为他们发生冠状动脉和其他动脉血栓形成的风险可能增加。未来需要进行前瞻性研究，以调查普鲁卡因胺治疗期间狼疮抗凝物的出现是否会增加血栓形成的风险。
