Mujic F, Lloyd M, Cuadrado M J, Khamashta M A, Hughes G R
Lupus Arthritis Research Unit, Rayne Institute, St. Thomas' Hospital, London, UK.
Clin Exp Rheumatol. 1995 May-Jun;13(3):327-31.
To assess the prevalence and clinical significance of subungual splinter haemorrhages in patients with the antiphospholipid syndrome.
A group of 147 patients with the antiphospholipid syndrome (124 female, 23 male) were studied. All patient histories were carefully reviewed and each patient was interviewed at least once. Particular attention was paid to clinical manifestations of the antiphospholipid syndrome at the time of subungual splinter haemorrhages. Patients who had evidence of infective endocarditis confirmed by echocardiogram and a positive blood culture were excluded from the study.
Six out of 147 patients developed subungual splinter haemorrhages. Amongst 80 patients (54%) with a history of venous thrombosis, only one developed subungual splinter haemorrhages during a lupus flare in the post-partum period. This sign was found in 4 out of 67 patients with arterial occlusions; in 2 of these the occlusion manifested as a cerebrovascular accident. Another patient with a history of lupus and recurrent miscarriages developed subungual splinter haemorrhages during a lupus flare.
Subungual splinter haemorrhages appeared to be relatively uncommon in our group of patients with the antiphospholipid syndrome. The differences in clinical setting and response to different treatment regimes in these cases suggest varied aetiopathologies and may reflect a number of different types of vascular insult.
评估抗磷脂综合征患者甲下裂片形出血的发生率及临床意义。
对147例抗磷脂综合征患者（124例女性，23例男性）进行研究。仔细回顾了所有患者的病史，且每位患者至少接受一次访谈。特别关注甲下裂片形出血时抗磷脂综合征的临床表现。经超声心动图证实有感染性心内膜炎且血培养呈阳性的患者被排除在研究之外。
147例患者中有6例出现甲下裂片形出血。在80例有静脉血栓形成病史的患者中（54%），只有1例在产后狼疮发作期间出现甲下裂片形出血。在67例有动脉闭塞的患者中有4例出现此体征；其中2例闭塞表现为脑血管意外。另1例有狼疮和反复流产病史的患者在狼疮发作期间出现甲下裂片形出血。
在我们的抗磷脂综合征患者组中，甲下裂片形出血似乎相对不常见。这些病例在临床情况和对不同治疗方案的反应方面存在差异，提示病因病理各异，可能反映了多种不同类型的血管损伤。
