Wahl D G, Guillemin F, de Maistre E, Perret C, Lecompte T, Thibaut G
Service de Medicine H., Nancy University Hospital, France.
Lupus. 1997;6(5):467-73. doi: 10.1177/096120339700600510.
To describe the relative risk for venous thrombosis (VT) associated with antiphospholipid antibodies (aPL) in systemic lupus erythematosus (SLE).
Systematic review and meta-analysis of 26 articles that examined the association between aPL and VT in SLE.
Mostly secondary and tertiary referral centres.
2249 patients with SLE, 1120 tested for LA (lupus anticoagulant) and 1563 tested for aCL (anticardiolipin antibodies).
A summary of study characteristics and a critical appraisal of study quality were done. Two statistical combinations of 18 primary studies that examined the association of VT and LA and of 14 studies that examined the association of VT and aCL were performed to estimate the risk for VT associated with aPL.
The odds ratios of the risk of VT related to the LA summarized from 18 studies were 5.61 [95% CI; 3.80-8.27] overall, 6.32 [CI; 3.71-10.78] for deep venous thrombosis and pulmonary embolism, 11.6 [3.65-36.91] for recurrent venous thrombosis after the first event. The odds ratios of the risk of VT related to aCL summarized from 14 studies were 2.17 [95% CI; 1.51-3.11] overall, 2.50 [CI; 1.51-4.14] for deep venous thrombosis and pulmonary embolism, 3.91 [1.14-13.38] for recurrent venous thrombosis after the first event.
Patients with SLE and LA are at approximately six times greater risk for VT than patients without LA, whereas patients with SLE and aCL are approximately two times greater risk for VT than patients without aCL. We have identified important methodologic limitations and differences in study characteristics. Other risk factors for VT have not been thoroughly evaluated in these studies. Further studies are needed that provide an accurate estimate of the absolute risk for aPL related VT.
描述系统性红斑狼疮（SLE）中抗磷脂抗体（aPL）与静脉血栓形成（VT）相关的相对风险。
对26篇研究SLE中aPL与VT关联的文章进行系统评价和荟萃分析。
主要为二级和三级转诊中心。
2249例SLE患者，1120例检测狼疮抗凝物（LA），1563例检测抗心磷脂抗体（aCL）。
对研究特征进行总结并对研究质量进行严格评估。对18项研究VT与LA关联以及14项研究VT与aCL关联进行两种统计合并，以估计aPL相关VT的风险。
18项研究汇总的与LA相关的VT风险比值比总体为5.61[95%可信区间（CI）；3.80 - 8.27]，深静脉血栓形成和肺栓塞为6.32[CI；3.71 - 10.78]，首次事件后复发性静脉血栓形成风险为11.6[3.65 - 36.91]。14项研究汇总的与aCL相关的VT风险比值比总体为2.17[95%CI；1.51 - 3.11]，深静脉血栓形成和肺栓塞为2.50[CI；1.51 - 4.14]，首次事件后复发性静脉血栓形成风险为3.91[1.14 - 13.38]。
SLE且有LA的患者发生VT的风险比无LA的患者高约6倍，而SLE且有aCL的患者发生VT的风险比无aCL的患者高约2倍。我们已确定研究特征方面存在重要的方法学局限性和差异。这些研究未对VT的其他风险因素进行全面评估。需要进一步研究以准确估计aPL相关VT的绝对风险。
