International PhD Program in Arterial Hypertension and Vascular Biology (ARHYVAB), University of Padua, Padua, Italy; Department of Endocrinology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
Thrombosis Research Laboratory, Department of Cardio-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy.
Thromb Res. 2022 Jun;214:106-114. doi: 10.1016/j.thromres.2022.04.021. Epub 2022 May 2.
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the presence of antiphospholipid antibodies (aPLs) and thrombotic events. The association of aPLs with thrombotic events depends on the number of positive tests. Besides the three classical tests to classify APS, phosphatidylserine/prothrombin complex autoantibodies (aPS/PT) are increasingly used to better define this condition. The aim of this systematic review was to evaluate the prevalence of aPS/PT in general and according to antiphospholipid antibody profiles in patients with APS.
A systematic search of PubMed, Web of Science, and the Cochrane Library from January 1990 to September 2021 was carried out according to PRISMA guidelines. Proportions and 95% confidence intervals (CIs) were calculated using random-effects model. Publication biases were evaluated via visualization of funnel plots along with Egger's and Begg's tests.
Twenty-one articles about the prevalence of aPS/PT in 1853 patients with APS were deemed eligible and analyzed according to the inclusion criteria. Pooled prevalence of aPS/PT IgG alone, IgM alone, and IgG/M were 50.0%, 45.0%, and 65.0%, respectively. No significant publication bias was detected from funnel plots or Egger's and Begg's tests. When the prevalence of aPS/PT was calculated in homogeneous aPLs, a much higher rate of pooled prevalence of aPS/PT IgG/M in patients positive for Lupus Anticoagulant (84.5%) and in those with triple positivity (83.4%) was found.
These data show a high rate of aPS/PT positivity in patients with APS (especially in those positive for LAC) but further studies are needed to ascertain whether this test might be useful in the laboratory classification criteria of APS.
抗磷脂综合征（APS）是一种自身免疫性疾病，其特征为存在抗磷脂抗体（aPLs）和血栓形成事件。aPLs 与血栓形成事件的关联取决于阳性检测的数量。除了用于分类 APS 的三种经典检测外，越来越多地使用磷脂酰丝氨酸/凝血酶原复合物自身抗体（aPS/PT）来更好地定义这种情况。本系统评价的目的是评估 APS 患者中一般情况下以及根据抗磷脂抗体谱中 aPS/PT 的患病率。
根据 PRISMA 指南，对 1990 年 1 月至 2021 年 9 月期间的 PubMed、Web of Science 和 Cochrane 图书馆进行了系统搜索。使用随机效应模型计算比例和 95%置信区间（CI）。通过可视化漏斗图以及 Egger 和 Begg 检验评估发表偏倚。
根据纳入标准，对 21 篇关于 APS 患者中 aPS/PT 患病率的文章进行了评估和分析，共纳入 1853 例 APS 患者。单独 IgG、单独 IgM 和 IgG/M 的 aPS/PT 阳性率分别为 50.0%、45.0%和 65.0%。从漏斗图或 Egger 和 Begg 检验中未发现显著的发表偏倚。当根据同质 aPLs 计算 aPS/PT 的患病率时，发现狼疮抗凝物（LAC）阳性和三联阳性患者的 aPS/PT IgG/M 总体阳性率更高（分别为 84.5%和 83.4%）。
这些数据表明 APS 患者中 aPS/PT 阳性率较高（尤其是 LAC 阳性患者），但需要进一步研究以确定该检测是否对 APS 的实验室分类标准有用。
