Kitagawa Y, Shinohara Y, Niwa K, Yoshitoshi M, Kametsu Y
Department of Neurology, Tokai University Oiso Hospital.
Rinsho Shinkeigaku. 1994 Aug;34(8):799-804.
Anticardiolipin antibody (aCL) is considered to be one of the contributory factors in the development of cerebral infarction. We compared the recurrence and prognosis of 20 ischemic stroke patients with positive IgG aCL who had no collagen vascular diseases with those in 120 patients with negative IgG aCL. The aCL-positive patients comprised 18 females and 2 males aged 43-79 (mean 64) years and the mean follow-up period was 5.6 years. The aCL-negative patients comprised 82 males and 38 females aged 40-84 (mean 64.2) years and the mean follow-up period was 5.8 years. There was no significant difference in age and mean follow-up period between the two groups. We examined the recurrence rate and the intervals from the onset to the recurrence in both groups. We investigated the relationship between the recurrence of stroke and chronological changes in titer of aCL in patients with positive aCL. We also evaluated the effectiveness of antiplatelet agents for the prevention of recurrent stroke in both groups. A positive aCL level was defined as one which was > 3 standard deviations (S.D.) above the mean level for normal controls. A high titer of aCL was defined as being > 7 S.D. above the normal mean value. Among the 20 patients with positive aCL, recurrence of ischemic stroke occurred in 10 (50%) (cerebral thrombosis in 8 and cerebral embolism in 2) and myocardial infarction developed in 2 patients. As regards the number of ischemic episodes of stroke, recurrence occurred twice in 4 and once in 6 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
抗心磷脂抗体(aCL)被认为是脑梗死发病的促成因素之一。我们比较了20例无胶原血管疾病且IgG aCL呈阳性的缺血性卒中患者与120例IgG aCL呈阴性患者的复发情况及预后。aCL阳性患者包括18名女性和2名男性,年龄在43 - 79岁(平均64岁),平均随访期为5.6年。aCL阴性患者包括82名男性和38名女性,年龄在40 - 84岁(平均64.2岁),平均随访期为5.8年。两组在年龄和平均随访期方面无显著差异。我们检查了两组的复发率以及从发病到复发的间隔时间。我们研究了aCL阳性患者中风复发与aCL滴度随时间变化之间的关系。我们还评估了抗血小板药物对两组预防复发性中风的有效性。aCL阳性水平定义为高于正常对照组平均水平3个标准差(S.D.)以上。aCL高滴度定义为高于正常平均值7个标准差以上。在20例aCL阳性患者中,10例(50%)发生了缺血性中风复发(8例为脑血栓形成,2例为脑栓塞),2例患者发生了心肌梗死。关于中风的缺血发作次数,4例患者复发两次,6例患者复发一次。(摘要截断于250字)