Berube C, Mitchell L, Silverman E, David M, Saint Cyr C, Laxer R, Adams M, Vegh P, Andrew M
Hamilton Civic Hospitals Research Centre, Ontario, Canada.
Pediatr Res. 1998 Sep;44(3):351-6. doi: 10.1203/00006450-199809000-00014.
The purpose of this study was to evaluate pediatric patients with systemic lupus erythematosus (SLE) to determine 1) the incidence of thrombosis, 2) the incidence of antiphospholipid antibodies, and 3) whether there is an association between the presence of antiphospholipid antibodies and thrombosis. We performed a cross-sectional cohort study in 59 consecutive SLE patients who had been managed at rheumatology clinics in two pediatric hospitals. A history, questionnaire, and chart review were completed by the study nurse blinded to laboratory results. Only the thrombotic events that could be substantiated by review of radiographic tests were accepted. The presence of antiphospholipid antibodies was determined by prospective analysis for a lupus anticoagulant and anticardiolipin antibodies on two separate occasions at least 3 mo apart. Patients were considered to be positive if one or more tests were positive on both occasions. Thirteen thrombotic events occurred in 10 of the 59 patients (17%). Fourteen patients (24%) were classified as positive for lupus anticoagulant, and 19 patients (27%) were classified as positive for anticardiolipin antibodies. A significant relationship between the presence of a lupus anticoagulant and a thrombotic event was shown: odds ratio 28.7 (95% confidence interval 4.03-138.2, p < 0.001). A nonsignificant trend was seen for the presence of an anticardiolipin antibody and a thrombotic event: odds ratio 2.12 (95% confidence interval 0.71-22.8, p=0.08). We conclude that in pediatric patients with SLE: 1) a significant proportion of patients have thrombotic events, 2) a significant proportion of patients have antiphospholipid antibodies, and 3) there is a significant relationship between the presence of a lupus anticoagulant and thrombotic events.
本研究的目的是评估患有系统性红斑狼疮（SLE）的儿科患者，以确定：1）血栓形成的发生率；2）抗磷脂抗体的发生率；3）抗磷脂抗体的存在与血栓形成之间是否存在关联。我们对连续59例在两家儿科医院的风湿病诊所接受治疗的SLE患者进行了一项横断面队列研究。研究护士在不知道实验室结果的情况下完成了病史、问卷调查和病历审查。只有通过影像学检查证实的血栓形成事件才被接受。抗磷脂抗体的存在通过前瞻性分析确定，分别在至少间隔3个月的两个不同时间检测狼疮抗凝物和抗心磷脂抗体。如果两次检测中一项或多项呈阳性，则患者被视为阳性。59例患者中有10例（17%）发生了13次血栓形成事件。14例患者（24%）狼疮抗凝物检测呈阳性，19例患者（27%）抗心磷脂抗体检测呈阳性。狼疮抗凝物的存在与血栓形成事件之间存在显著关系：比值比为28.7（95%置信区间4.03 - 138.2，p < 0.001）。抗心磷脂抗体的存在与血栓形成事件之间存在不显著的趋势：比值比为2.12（95%置信区间0.71 - 22.8，p = 0.08）。我们得出结论，在患有SLE的儿科患者中：1）相当比例的患者发生血栓形成事件；2）相当比例的患者存在抗磷脂抗体；3）狼疮抗凝物的存在与血栓形成事件之间存在显著关系。
