Gazengel C, Dougados M, Kremp O, Tron F, Noël L H, Jungers P
Nouv Presse Med. 1980 Sep 20;9(33):2325-8.
Circulating anticoagulants with antiprothrombinase activity were detected in 14 out of 49 patients (i.e. 29%) presenting with severe forms of systemic lupus erythematosus (SLE) predominantly renal (29) or extrarenal (20). Nine of these 14 patients had thrombopenia and 8 had a falsely positive Wassermann test. The anticoagulants were more frequently encountered in patients with severe extrarenal manifestations (9/20 cases) than in patients with severe proliferative renal lesions (5/29 cases). They were found in 5 out of 10 patients with arterial and/or venous thrombosis. Anticoagulant levels paralleled the course of the disease during treatment. No haemorrhage was observed in 14 percutaneous renal biopsies performed on 11 patients free from outer coagulopathies. This suggests that the presence of antiprothrombinase anticoagulants in the blood of patients without thrombopenia or other coagulation disorders is compatible with surgery or biopsy of the kidney.
在49例主要表现为肾脏(29例)或肾外(20例)病变的重症系统性红斑狼疮(SLE)患者中,检测到14例(即29%)存在具有抗凝血酶原酶活性的循环抗凝物质。这14例患者中,9例有血小板减少症,8例梅毒血清试验呈假阳性。与有严重增殖性肾损害的患者(5/29例)相比,抗凝物质在有严重肾外表现的患者中更常见(9/20例)。在10例有动脉和/或静脉血栓形成的患者中,有5例发现了抗凝物质。治疗期间,抗凝物质水平与疾病进程平行。对11例无外在凝血障碍的患者进行了14次经皮肾活检,未观察到出血情况。这表明,在无血小板减少症或其他凝血障碍的患者血液中存在抗凝血酶原酶抗凝物质时,进行肾脏手术或活检是可行的。