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抗心磷脂抗体与巨细胞动脉炎:一项前瞻性多中心病例对照研究。巨细胞动脉炎研究小组

Anticardiolipin antibodies and giant cell arteritis: a prospective, multicenter case-control study. Groupe de Recherche sur l'Artérite à Cellules Géantes.

作者信息

Duhaut P, Berruyer M, Pinede L, Demolombe-Rague S, Loire R, Seydoux D, Dechavanne M, Ninet J, Pasquier J

机构信息

Edouard Herriot Hospital, Lyon, France.

出版信息

Arthritis Rheum. 1998 Apr;41(4):701-9. doi: 10.1002/1529-0131(199804)41:4<701::AID-ART18>3.0.CO;2-P.

Abstract

OBJECTIVE

To assess the prevalence and thrombogenic role of anticardiolipin antibodies (aCL) in giant cell arteritis.

METHODS

Two hundred eighty-four patients with newly diagnosed temporal arteritis or polymyalgia rheumatica and 210 age- and sex-matched controls randomly selected from the general population were included in a multicenter, prospective case-control study. Blood samples were obtained at the time of diagnosis, data on initial clinical features were collected in a questionnaire, and temporal artery biopsy findings were reviewed by an experienced pathologist.

RESULTS

Anticardiolipin antibodies were present in 20.7% of patients compared with 2.9% of controls (P = 1.45 x 10(-9)). The prevalence of aCL was higher in samples found positive for temporal arteritis than in those found negative on biopsy (31.2% versus 16.7%; P = 0.04), and was similarly higher in the biopsy-positive temporal arteritis group compared with the polymyalgia rheumatica and control groups. Although aCL were associated with thrombotic complications in univariate analysis, the positivity of the biopsy findings remained the only predictive variable in stratified analysis.

CONCLUSION

In giant cell arteritis, aCL seem to function as reactive antibodies in relation to endothelial lesions.

摘要

目的

评估抗心磷脂抗体(aCL)在巨细胞动脉炎中的患病率及其促血栓形成作用。

方法

一项多中心前瞻性病例对照研究纳入了284例新诊断的颞动脉炎或风湿性多肌痛患者以及210例从普通人群中随机选取的年龄和性别匹配的对照者。在诊断时采集血样,通过问卷收集初始临床特征数据,并由经验丰富的病理学家复查颞动脉活检结果。

结果

20.7%的患者存在抗心磷脂抗体,而对照组这一比例为2.9%(P = 1.45×10⁻⁹)。颞动脉炎活检阳性样本中aCL的患病率高于活检阴性样本(31.2%对16.7%;P = 0.04),与风湿性多肌痛组和对照组相比,活检阳性的颞动脉炎组中aCL患病率同样更高。虽然单因素分析中aCL与血栓形成并发症相关,但在分层分析中,活检结果阳性仍然是唯一的预测变量。

结论

在巨细胞动脉炎中,aCL似乎是与内皮病变相关的反应性抗体。

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