Algahtani Farjah H, AlQahtany Fatmah S, ElGohary Ghada, Alsharidi Aynaa, Sayeeda Afsar, AlArfaj Hussein, Gamal Ahmed Y
Department of Medicine, Division of Oncology/Hematology, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia.
Department of Pathology, Hematopathology Unit, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia.
Saudi J Biol Sci. 2020 Sep;27(9):2425-2430. doi: 10.1016/j.sjbs.2020.05.037. Epub 2020 May 29.
Antiphospholipid syndrome is a organized autoimmune disease presented with vascular thrombosis and pregnancy morbidity. The Sapporo classification criteria of APS were revised in 2006 and are used as the main diagnosis guideline, which validity as standard measurements is still in debate. This study observe the clinical and laboratory indices of APS among Saudi patients. This is a retrospective study hospital-based population. The clinical and Laboratory manifestations of diagnosed APS patients from electronical medical records identifies by ICD-9 code 795.79 in the King Saud University Medical City, Riyadh, Saudi Arabia, between 1990 and 2012. We selected patients with ICD-9 code 795.79 as. Sapporo criteria applied to all patients, then divided into cases fulfilled criteria and cases failed the criteria. To notice the difference in clinical and laboratory indices and comorbidities between the two groups, the T-test was performed and Logistic regression for the fulfilled criteria and clinical indices of vascular thrombosis, DVT/PE, recurrent, and pregnancy morbidity. A total of 72 (90%) females and 8 (10%) males, with the female-to-male ratio 9:1. The mean (±SD) age at diagnosis was 28.1 (±8.7) years (range 11-63 years). There were 22 patients (27.5%) attained the revised criteria (APS confirmed) and no significant difference between the two groups was observed (p > 0.2). However, we found Sapporo confirmed APS cases had significantly higher percentage of serological manifestation presence than clinically diagnosed APS cases. Though there is no statistically significance, Sapporo confirmed APS cases had advanced odds of undergoing vascular thrombosis (OR = 1.61, 95%CI) and DVT/PE (OR = 1.53, 95%CI) and lesser odds of undergoing recurrent DVT/PE (OR = 0.67, 95%CI) and pregnancy morbidity (OR = 0.63, 95%CI) than the clinically diagnosed APS cases. Over 70% of the study population with diagnosed APS did not accomplish the revised Sapporo criteria due to negative laboratory manifestations, which reflects heterogeneous but not degreed disease severity profiles.
抗磷脂综合征是一种伴有血管血栓形成和妊娠并发症的系统性自身免疫性疾病。2006年修订了抗磷脂综合征的札幌分类标准，并将其用作主要诊断指南，但其作为标准测量方法的有效性仍存在争议。本研究观察了沙特患者中抗磷脂综合征的临床和实验室指标。这是一项基于医院人群的回顾性研究。通过沙特阿拉伯利雅得国王沙特大学医学城1990年至2012年间电子病历中ICD - 9编码795.79确定诊断为抗磷脂综合征患者的临床和实验室表现。我们选择ICD - 9编码795.79的患者作为研究对象。将札幌标准应用于所有患者，然后分为符合标准的病例和不符合标准的病例。为了观察两组之间临床和实验室指标及合并症的差异，进行了t检验，并对符合标准的病例以及血管血栓形成、深静脉血栓形成/肺栓塞、复发性和妊娠并发症的临床指标进行了逻辑回归分析。共有72名（90%）女性和8名（10%）男性，男女比例为9:1。诊断时的平均（±标准差）年龄为28.1（±8.7）岁（范围11 - 63岁）。有22名患者（27.5%）符合修订标准（抗磷脂综合征确诊），两组之间未观察到显著差异（p>0.2）。然而，我们发现札幌确诊的抗磷脂综合征病例血清学表现阳性的百分比显著高于临床诊断的抗磷脂综合征病例。尽管无统计学意义，但札幌确诊的抗磷脂综合征病例发生血管血栓形成（OR = 1.61，95%CI）和深静脉血栓形成/肺栓塞（OR = 1.53，95%CI）的几率高于临床诊断的抗磷脂综合征病例，而复发性深静脉血栓形成/肺栓塞（OR = 0.67，95%CI）和妊娠并发症（OR = 0.63，95%CI）的几率低于临床诊断的抗磷脂综合征病例。超过70%诊断为抗磷脂综合征的研究人群因实验室表现阴性未达到修订的札幌标准，这反映了疾病严重程度的异质性而非程度差异。
