Metz L M, Edworthy S, Mydlarski R, Fritzler M J
Department of Clinical Neurosciences, Foothills Hospital, University of Calgary, Alberta, Canada.
Can J Neurol Sci. 1998 Feb;25(1):64-9. doi: 10.1017/s0317167100033515.
Antibodies to cardiolipin and other phospholipids have been associated with recurrent thrombotic events, including stroke.
Over a 16 month period we assessed an unselected cohort of 151 ischemic stroke patients for the presence of antiphospholipid antibodies. Patients with known systemic lupus erythematosis, systemic sclerosis, or Sjögrens Syndrome were excluded. Sera from patients admitted to hospital with a diagnosis of ischemic stroke (n = 151) and from controls (n = 111) assessed during the same period were tested for antiphospholipid antibodies (APLA) using 3 assays; anticardiolipin antibodies (ACA) by ELISA, prolonged activated partial thromboplastin time (APTT), and VDRL.
The average age of ischemic stroke cases was 68 years (range 29 to 91) and of controls 63 years (range 29 to 86). The prevalence of APLA detected by at least one of the three methods was 12% for IS cases and 10% for controls. After correcting for known risk factors such as age, gender, diabetes mellitus, heart disease, hypertension, and smoking, the odds ratio for risk of stroke fell to 0.8 (C.I. 0.4 to 1.2).
Our findings suggest that APLA may not be an independent risk factor for ischemic stroke in unselected persons who do not have known systemic lupus erythematosis or systemic sclerosis but further evaluation of the role of lupus anticoagulant is indicated.
抗心磷脂抗体及其他磷脂抗体与包括中风在内的复发性血栓形成事件有关。
在16个月的时间里，我们对151例缺血性中风患者的非选择性队列进行了抗磷脂抗体检测。排除已知患有系统性红斑狼疮、系统性硬化症或干燥综合征的患者。采用3种检测方法对同期入院诊断为缺血性中风的患者（n = 151）和对照组（n = 111）的血清进行抗磷脂抗体（APLA）检测；通过酶联免疫吸附测定法检测抗心磷脂抗体（ACA），检测活化部分凝血活酶时间（APTT）延长情况及性病研究实验室试验（VDRL）。
缺血性中风病例的平均年龄为68岁（范围29至91岁），对照组为63岁（范围29至86岁）。通过三种方法中至少一种检测到的APLA患病率，缺血性中风病例为12%，对照组为10%。在校正年龄、性别、糖尿病、心脏病、高血压和吸烟等已知风险因素后，中风风险的比值比降至0.8（置信区间0.4至1.2）。
我们的研究结果表明，在无已知系统性红斑狼疮或系统性硬化症的非选择性人群中，APLA可能不是缺血性中风的独立危险因素，但需要进一步评估狼疮抗凝物的作用。
