Font J, López-Soto A, Cervera R, Casals F J, Reverter J C, Muñoz F J, Miret C, Bové A, Ordinas A, Ingelmo M
Systemic Autoimmune Diseases Unit, Hospital Clínic, Barcelona, Catalonia, Spain.
Thromb Res. 1997 Apr 1;86(1):37-48. doi: 10.1016/s0049-3848(97)00043-1.
We determined the prevalence and relationship with clinical manifestations of antibodies to thromboplastin (aTP) in 92 patients with systemic lupus erythematosus (SLE). Thirty-two (35%) patients had aTP: 13 (14%) were positive for IgG aTP, 13 (14%) for IgM aTP, and 6 (7%) for both. Patients with aTP had an increased incidence of thrombosis (p = 0.01), thrombocytopenia (p < 0.001), hemolytic anemia (p < 0.001), and fetal losses (p = 0.03). When the IgG and IgM aTP isotypes were analysed separately, the IgG aTP were found to be associated with thrombosis (p < 0.001), thrombocytopenia (p < 0.001), and fetal losses (p = 0.02). The IgM aTP were associated with hemolytic anemia (p < 0.001). A correlation was found between the titers of aTP and those of anticardiolipin antibodies, in both IgG (p < 0.01, r = 0.6) and IgM (p < 0.01, r = 0.64) isotypes, and between the titers of IgG aTP and the diluted Russell's viper venom time used to detect the lupus anticoagulant (p < 0.001, r = 0.42). This test is a reliable, reproducible and sensitive assay for the detection of antiphospholipid antibodies, specially in those patients under anticoagulant therapy.
我们测定了92例系统性红斑狼疮（SLE）患者中凝血活酶抗体（aTP）的患病率及其与临床表现的关系。32例（35%）患者存在aTP：13例（14%）IgG aTP阳性，13例（14%）IgM aTP阳性，6例（7%）两者均阳性。aTP阳性患者的血栓形成发生率增加（p = 0.01）、血小板减少（p < 0.001）、溶血性贫血（p < 0.001）及胎儿丢失发生率增加（p = 0.03）。当分别分析IgG和IgM aTP同种型时，发现IgG aTP与血栓形成（p < 0.001）、血小板减少（p < 0.001）及胎儿丢失（p = 0.02）相关。IgM aTP与溶血性贫血相关（p < 0.001）。在IgG（p < 0.01，r = 0.6）和IgM（p < 0.01，r = 0.64）同种型中，均发现aTP滴度与抗心磷脂抗体滴度之间存在相关性，并且在IgG aTP滴度与用于检测狼疮抗凝物的稀释蝰蛇毒时间之间存在相关性（p < 0.001，r = 0.42）。该检测对于抗磷脂抗体的检测是一种可靠、可重复且敏感的测定方法，尤其适用于接受抗凝治疗的患者。
