Ford S E, Kennedy L, Ford P M
Department of Pathology, Queen's University, Kingston, Ontario.
Arch Pathol Lab Med. 1994 May;118(5):491-5.
The clinicopathologic correlations of antiphospholipid antibodies (aPLs) have so far only been examined in case reports and highly selected series. This study assessed the incidence of aPLs in 156 consecutive, unselected autopsies and correlated the pathological findings with the clinical histories. Elevations of aPLs were found in 20.5% of the autopsy population, compared with 9.6% of age- and sex-matched controls and 2% of healthy normal subjects. There was a higher incidence of thromboembolic disease in patients with elevated aPL levels compared with those without, but the histology of thrombi was similar in both groups, with no evidence of vasculitis in the aPL-positive individuals. Patients with transient ischemic attacks and cardiac valve lesions had a high incidence of aPLs, as reported previously. Five cases that fit the designation of primary antiphospolipid antibody syndrome were noted. The study concludes that aPLs are relatively common in a hospital autopsy population and are commonly associated with thromboembolic events, that the thromboemboli are not associated with vasculitis, and that primary aPL syndrome is more common than generally appreciated.
迄今为止，抗磷脂抗体（aPLs）的临床病理相关性仅在病例报告和高度选择性的系列研究中得到检验。本研究评估了156例连续、未经选择的尸检中aPLs的发生率，并将病理结果与临床病史相关联。在20.5%的尸检人群中发现aPLs升高，相比之下，年龄和性别匹配的对照组中这一比例为9.6%，健康正常受试者中为2%。与aPL水平未升高的患者相比，aPL水平升高的患者血栓栓塞性疾病的发生率更高，但两组血栓的组织学相似，aPL阳性个体中无血管炎证据。如先前报道，短暂性脑缺血发作和心脏瓣膜病变患者中aPLs的发生率较高。记录到5例符合原发性抗磷脂抗体综合征诊断的病例。该研究得出结论，aPLs在医院尸检人群中相对常见，且通常与血栓栓塞事件相关，血栓栓塞与血管炎无关，原发性aPL综合征比普遍认为的更为常见。
