Provenzale J M, Ortel T L, Allen N B
Department of Radiology, Duke University Medical Center, Durham, NC 27710-3808, USA.
AJR Am J Roentgenol. 1998 Feb;170(2):285-90. doi: 10.2214/ajr.170.2.9456930.
The purpose of this study was to determine the patterns of non-CNS thromboses in patients with a hypercoagulable state associated with antiphospholipid antibodies (APA).
A search of our institution's clinical coagulation and immunology laboratories' records of patients examined from January 1993 to January 1996 revealed 1290 patients with APA. Computerized records of radiologic studies were reviewed for evidence of thrombotic events, which were found in 93 patients (49 males and 44 females; average age, 40 years). The anatomic distribution of thrombotic events was recorded.
Fifty-five patients (59%; 29 males and 26 females; average age, 44.2 years) had solely venous thromboses, 26 patients (28%; 15 males and 11 females; average age, 33.1 years) had solely arterial thromboses, and 12 (13%; 5 males and 7 females; average age, 35.4 years) had both types of events. Deep vein thrombosis (DVT) of the legs was the most common finding, occurring in 45 patients (48%). Six patients had recurrent DVT. Other sites of venous thrombotic events included pulmonary embolism, 30 patients (32%); thoracic veins (superior vena cava, subclavian vein, or jugular vein), 10 patients (11%); and abdominal or pelvic veins, 18 events in 11 patients (12%). Sites of arterial thromboses included arteries supplying the upper limbs (great vessels arising from the aorta or the brachial, radial, ulnar, or digital arteries), 15 events in 12 patients (13%); aorta, one patient (1%); abdominal or pelvic arteries, 11 events in eight patients (9%); and arteries supplying the lower limbs (femoral or popliteal arteries), seven patients (8%).
Venous thromboses were more common than arterial thromboses in our patient group, with DVT being the most common. However, thromboses in sites that are unusual for the general population were also relatively common. APA should be suspected in patients with thromboses in unusual sites or recurrent thromboses of an otherwise unexplained cause.
本研究旨在确定抗磷脂抗体（APA）相关高凝状态患者中非中枢神经系统血栓形成的模式。
检索我院1993年1月至1996年1月临床凝血和免疫实验室检查患者的记录，共发现1290例APA患者。回顾放射学研究的计算机记录以寻找血栓形成事件的证据，93例患者（49例男性和44例女性；平均年龄40岁）发现有血栓形成事件。记录血栓形成事件的解剖分布。
55例患者（59%；29例男性和26例女性；平均年龄44.2岁）仅有静脉血栓形成，26例患者（28%；15例男性和11例女性；平均年龄33.1岁）仅有动脉血栓形成，12例患者（13%；5例男性和7例女性；平均年龄35.4岁）两种类型的事件均有。腿部深静脉血栓形成（DVT）是最常见的发现，45例患者（48%）出现。6例患者发生复发性DVT。静脉血栓形成事件的其他部位包括肺栓塞，30例患者（32%）；胸段静脉（上腔静脉、锁骨下静脉或颈静脉），10例患者（11%）；腹部或盆腔静脉，11例患者有18次事件（12%）。动脉血栓形成的部位包括供应上肢的动脉（发自主动脉或肱动脉、桡动脉、尺动脉或指动脉的大血管），12例患者有15次事件（13%）；主动脉，1例患者（1%）；腹部或盆腔动脉，8例患者有11次事件（9%）；供应下肢的动脉（股动脉或腘动脉），7例患者（8%）。
在我们的患者组中，静脉血栓形成比动脉血栓形成更常见，DVT最为常见。然而，在一般人群中不常见部位的血栓形成也相对常见。对于不常见部位血栓形成或原因不明的复发性血栓形成患者，应怀疑有APA。
