Sorbonne Université, AP-HP, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Hôpital Saint-Antoine, F-75012, Paris, France.
Service de médecine médecine interne, AP-HP.Nord, Hôpital Beaujon, Université de Paris, Clichy, France.
RMD Open. 2023 Mar;9(1). doi: 10.1136/rmdopen-2022-002534.
Antiphospholipid syndrome (APS) is defined by the association of thromboembolic and/or obstetrical clinical manifestations and the presence of antiphospholipid antibodies. The objective of our study was to evaluate the impact of the triple-positive profile in a cohort of 204 APS patients.
We conducted a retrospective study, including patients with primary or secondary APS, meeting the Sydney criteria with at least one thrombotic and/or obstetrical complication. Clinical characteristics and the risk of relapse (defined by the occurrence of a new thrombotic event and/or a new adverse obstetrical event) between triple-positive and non-triple-positive APS patients were compared.
204 patients were included in our study, 68 were triple-positive and 136 were single or double positive. 122 patients (59.8%) had primary APS. 67 patients (32.8%) had obstetrical APS, with a higher rate among triple-positive patients (45.6% vs 26.5%, p=0.010), and 170 patients (83.3%) had thrombotic APS, without difference between triple-positive and others. Thrombotic events were more often venous (56.4%) than arterial (37.7%). Triple-positive patients had more placental complications than others (17.6% vs 2.9%, p=0.001) and more non-criteria events (48.5% vs 25.7%, p=0.002). Among non-criteria events, there was a higher frequency of Sneddon syndrome in triple-positive patients (7.4% vs 0.7%, p=0.028). The relapse rate was higher in triple-positive patients than in others (63.2% vs 39,7%, p=0002). In multivariate analysis, the triple-positive profile was associated with a higher risk of relapse (HR 1.63; 95% CI 1.04 to 2.55; p=0.031).
The triple-positivity is associated with a higher risk of relapse and obstetrical complications.
抗磷脂综合征（APS）的定义为血栓栓塞和/或产科临床表现以及存在抗磷脂抗体。我们研究的目的是评估三联阳性谱在 204 例 APS 患者中的影响。
我们进行了一项回顾性研究，包括符合悉尼标准且至少有一次血栓形成和/或产科并发症的原发性或继发性 APS 患者。比较三联阳性和非三联阳性 APS 患者之间的临床特征和复发风险（定义为新的血栓事件和/或新的不良产科事件的发生）。
本研究共纳入 204 例患者，68 例为三联阳性，136 例为单阳性或双阳性。122 例（59.8%）为原发性 APS。67 例（32.8%）为产科 APS，三联阳性患者发生率较高（45.6%比 26.5%，p=0.010），170 例（83.3%）为血栓性 APS，三联阳性与其他患者之间无差异。血栓事件主要为静脉血栓（56.4%）而非动脉血栓（37.7%）。三联阳性患者比其他患者更易发生胎盘并发症（17.6%比 2.9%，p=0.001）和非标准事件（48.5%比 25.7%，p=0.002）。在非标准事件中，三联阳性患者更常见 Sneddon 综合征（7.4%比 0.7%，p=0.028）。三联阳性患者的复发率高于其他患者（63.2%比 39.7%，p=0.0002）。多变量分析显示，三联阳性谱与更高的复发风险相关（HR 1.63；95%CI 1.04 至 2.55；p=0.031）。
三联阳性与更高的复发风险和产科并发症相关。
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