抗磷脂抗体在大动脉炎中的作用。
The impact of antiphospholipid antibodies in Takayasu arteritis.
机构信息
Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey.
出版信息
Turk J Med Sci. 2023 Feb;53(1):199-205. doi: 10.55730/1300-0144.5573. Epub 2023 Feb 22.
BACKGROUND
The significance of antiphospholipid antibodies (aPL) is controversial in Takayasu arteritis (TA). This study was conducted to explore the frequency of aPL and their association with disease-related complications in TA.
METHODS
: This cross-sectional study was conducted to investigate the presence of anti-cardiolipin (aCL), anti-beta 2 glycoprotein- 1(aβ2G1) antibodies, and lupus anticoagulant (LA) in TA patients. TA patients admitted to the Department of Rheumatology of Hacettepe University Faculty of Medicine between December 2015 and September 2016 who fulfilled the American College of Rheumatology (ACR) classification criteria for TA were consecutively enrolled in the study. Patients were grouped according to aPL positivity and compared in terms of disease manifestations, type of vascular involvement at diagnosis, and vascular complications/interventions attributable to TA.
RESULTS
Fifty-three TA (49 female) patients were enrolled in the study. We detected 9 (16.9%) patients with IgM and/or IgG aβ2G1 and/or LA positivity. There were no patients with positive aCL. All aβ2G1 titers were low. There were no differences in terms of symptoms, signs, type of vascular involvement, the number of patients with disease-related complications or vascular interventions/surgery between aPL (+) and aPL(-) groups (p > 0.05 for all). The number of patients with thrombotic lesions was similar between the groups (p > 0.05). There were no patients with a history of venous thrombosis or on anticoagulant treatment in the aPL(+) group. Only 1 patient with IgM aβ2G1 (+) had a history of pregnancy loss.
DISCUSSION
Our results indicate that aPL positivity is not rare in TA. On the other hand, all aPL titers were low and no differences were found in the frequency of disease-related complications between aPL(+) and aPL(-) patient groups. Only TA patients with atypical manifestations with high suspicion of aPL-related complications should be considered to be investigated for aPL.
背景
抗磷脂抗体（aPL）在大动脉炎（TA）中的意义仍存在争议。本研究旨在探讨 TA 患者 aPL 的频率及其与疾病相关并发症的关系。
方法
本横断面研究纳入了 2015 年 12 月至 2016 年 9 月期间连续入住土耳其哈塞特佩大学医学院风湿病科的符合美国风湿病学会（ACR）大动脉炎分类标准的 TA 患者。检测患者抗心磷脂（aCL）、抗β2 糖蛋白 1（aβ2G1）抗体和狼疮抗凝物（LA）的存在情况。根据 aPL 阳性情况将患者分组，并比较两组患者的疾病表现、诊断时血管受累类型以及归因于 TA 的血管并发症/干预情况。
结果
本研究共纳入 53 例 TA（49 例女性）患者。我们检测到 9 例（16.9%）患者的 IgM 和/或 IgG aβ2G1 和/或 LA 阳性。无 aCL 阳性患者。所有 aβ2G1 滴度均较低。aPL（+）组与 aPL（-）组在症状、体征、血管受累类型、疾病相关并发症或血管干预/手术患者数量等方面均无差异（所有 p 值>0.05）。两组患者的血栓形成病变数量相似（p 值>0.05）。aPL（+）组中无静脉血栓形成或正在接受抗凝治疗的患者。仅有 1 例 IgM aβ2G1（+）患者有妊娠丢失病史。
讨论
我们的研究结果表明，TA 患者中 aPL 阳性并不罕见。另一方面，所有 aPL 滴度均较低，且 aPL（+）组与 aPL（-）组患者的疾病相关并发症发生率无差异。只有表现不典型且高度怀疑与 aPL 相关并发症的 TA 患者才应考虑进行 aPL 检查。
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