Gschwandtner M E, Eichinger S, Hütter D, Korninger L, Lechner K, Panzer S, Pabinger I
Department of Haematology and Blood Coagulation, University of Vienna, Austria.
Blood Coagul Fibrinolysis. 1996 Apr;7(3):325-30.
It has been speculated that an impairment in anticoagulant pathways (protein C (PC), protein S (PS), resistance to activated protein C (APC)), may contribute to the thrombotic tendency in lupus anticoagulant (LA) patients. Increased plasma levels of fibrinogen are predictive for arterial thrombosis and increased molecular markers of thrombosis are indicative for activation of the clotting cascade. We investigated 25 patients (20 women) with LA. All patients were stratified according to their thromboembolic history and women according to their history of fetal loss. Eighteen patients had a history of venous or arterial thrombosis, or both. Seven of 16 women with at least one pregnancy had a history of fetal loss. The interrelation among the levels of fibrinogen, PC and PS, and resistance to APC, thrombin-antithrombin III complexes (TAT), prothrombin fragment F1 + 2, D-dimer and the history of thrombotic events and obstetric complications in patients with LA were evaluated. LA patients with a history of venous or arterial thrombosis had a significantly higher fibrinogen level than LA patients without (mean 366 versus 304 mg/dl; P = 0.018). Among 16 women a slightly lower mean TAT level in women with fetal loss was found (2.4 versus 4.3 ng/ml; P = 0.02). No other statistically significant difference in the remaining parameters was yielded in both analyzed subgroups. The results of the study suggest an association between increased fibrinogen levels and the history of venous or arterial thrombosis, or both, in patients with LA. In the other investigated parameters, no relationship to the thrombotic or obstetric history was found.
据推测，抗凝途径（蛋白C（PC）、蛋白S（PS）、对活化蛋白C（APC）的抵抗）受损可能导致狼疮抗凝物（LA）患者的血栓形成倾向。纤维蛋白原血浆水平升高可预测动脉血栓形成，而血栓形成的分子标志物增加则表明凝血级联反应被激活。我们研究了25例LA患者（20例女性）。所有患者根据其血栓栓塞病史进行分层，女性患者根据其流产病史进行分层。18例患者有静脉或动脉血栓形成病史，或两者皆有。16例至少有一次妊娠的女性中有7例有流产病史。评估了LA患者纤维蛋白原、PC和PS水平、对APC的抵抗、凝血酶-抗凝血酶III复合物（TAT）、凝血酶原片段F1 + 2、D-二聚体水平与血栓形成事件和产科并发症病史之间的相互关系。有静脉或动脉血栓形成病史的LA患者纤维蛋白原水平显著高于无此病史的LA患者（平均366对304 mg/dl；P = 0.018）。在16例女性中，发现有流产史的女性平均TAT水平略低（2.4对4.3 ng/ml；P = 0.02）。在两个分析亚组中，其余参数均未产生其他统计学显著差异。研究结果表明，LA患者纤维蛋白原水平升高与静脉或动脉血栓形成病史或两者皆有之间存在关联。在其他研究参数中，未发现与血栓形成或产科病史有关。
