Nojima J, Suehisa E, Kuratsune H, Machii T, Toku M, Tada H, Yamaguti K, Koike T, Kanakura Y, Kitani T, Amino N
The Central Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Japan.
Am J Hematol. 1998 May;58(1):55-60. doi: 10.1002/(sici)1096-8652(199805)58:1<55::aid-ajh10>3.0.co;2-4.
The relationship between thrombocytopenia and the level of anticardiolipin antibodies (aCL) and/or the existence of lupus anticoagulant (LA) ware studied in 146 patients with systemic lupus erythematosus (SLE). These patients were divided into six groups: A, those LA positive with a high level of aCL (>10 U/ml) (10 cases); B, those LA positive with a low level of aCL (3-10 U/ml) (15 cases); C, those LA positive but aCL negative (<3 U/ml) (12 cases); D, LA negatives with a high level of aCL (12 cases); E, LA negatives with a low level of aCL (16 cases); and F, aCL and LA double negatives (81 cases). The prevalence of thrombocytopenia (platelet count < or = 100 x 10(9)L) was by far the highest in group A (9/10 cases, 90.0%, P < 0.005, Fisher's exact probability test) as compared with group B (4/15 cases, 26.7%), group C (4/12 cases, 33.3%), group D (1/12 cases, 8.3%), group E (4/16 cases, 25.5%), and group F (9/81 cases, 11.1%). When the relationship between moderate thrombocytopenia and arterial or venous thrombosis was studied in these patients with SLE, thrombocytopenia was detected in 10 (83.3%, P < 0.005, Fisher's exact probability test) of 12 patients with arterial thrombosis; however, it was present in only 4 (23.5%) of 17 patients with venous thrombosis and in 14 (12.3%) of 114 patients without thrombosis. These findings suggest that a high aCL activity combined with LA positively reflects a high risk for both thrombocytopenia and arterial thrombosis.
在146例系统性红斑狼疮（SLE）患者中研究了血小板减少症与抗心磷脂抗体（aCL）水平和/或狼疮抗凝物（LA）存在之间的关系。这些患者被分为六组：A组，LA阳性且aCL水平高（>10 U/ml）（10例）；B组，LA阳性且aCL水平低（3 - 10 U/ml）（15例）；C组，LA阳性但aCL阴性（<3 U/ml）（12例）；D组，LA阴性且aCL水平高（12例）；E组，LA阴性且aCL水平低（16例）；F组，aCL和LA均为阴性（81例）。与B组（4/15例，26.7%）、C组（4/12例，33.3%）、D组（1/12例，8.3%）、E组（4/16例，25.5%）和F组（9/81例，11.1%）相比，A组血小板减少症（血小板计数≤100×10⁹/L）的患病率最高（9/10例，90.0%，P<0.005，Fisher精确概率检验）。在这些SLE患者中研究中度血小板减少症与动脉或静脉血栓形成的关系时，12例动脉血栓形成患者中有10例（83.3%，P<0.005，Fisher精确概率检验）检测到血小板减少症；然而，17例静脉血栓形成患者中只有4例（23.5%）存在血小板减少症，114例无血栓形成患者中有14例（12.3%）存在血小板减少症。这些发现表明，高aCL活性与LA阳性共同反映了血小板减少症和动脉血栓形成的高风险。
