Costallat L T, Ribeiro C C, Annichino-Bizzacchi J M
Departament of Internal Medicine, State University of Campinas, UNICAMP, Brasil.
Sangre (Barc). 1998 Oct;43(5):345-8.
Patients with systemic lupus erythematosus (SLE) have an increased risk of thrombosis, related to the lupus anticoagulant or anticardiolipin antibodies (ACL). Antithrombin (AT), protein C (PC) and protein S are natural anticoagulants with a very important role in the regulation of coagulation and fibrinolysis, and in the prevention of thrombosis. Total protein S (TPS), free protein S (FPS), AT and PC were measured in 53 unselected patients with SLE in order to verify their relation with previous history of thrombosis or the presence of anticardiolipin antibodies (ACL). The influence of prednisone use on the concentration of these natural anticoagulants was also analysed. The control group was formed by 20 blood donors. The PC concentration was increased in patients with ACL, when compared to controls (p < 0.01), or patients without ACL (p = 0.01). FPS levels were decreased in patients with SLE in relation to controls (p = 0.01), but not related to thrombosis or ACL. There was no difference in plasmatic concentration of AT and TPS, between patients and controls. PC, AT and TPS were increased in patients under prednisone use (p < 0.01). There was no association between concentration of natural anticoagulants and a history of thrombosis. Although decreased FPS was found, or results suggest that it seems not to be a risk factor for thrombosis in SLE. Since PC and AT were not decreased, they should not be involved with thromboembolic complications in these patients. The use of prednisone can influence concentration of natural anticoagulants in patients with SLE.
系统性红斑狼疮（SLE）患者发生血栓形成的风险增加，这与狼疮抗凝物或抗心磷脂抗体（ACL）有关。抗凝血酶（AT）、蛋白C（PC）和蛋白S是天然抗凝剂，在凝血和纤维蛋白溶解的调节以及血栓形成的预防中起着非常重要的作用。为了验证它们与既往血栓形成病史或抗心磷脂抗体（ACL）的存在之间的关系，对53例未经选择的SLE患者进行了总蛋白S（TPS）、游离蛋白S（FPS）、AT和PC的检测。还分析了泼尼松的使用对这些天然抗凝剂浓度的影响。对照组由20名献血者组成。与对照组（p < 0.01）或无ACL的患者（p = 0.01）相比，ACL患者的PC浓度升高。与对照组相比，SLE患者的FPS水平降低（p = 0.01），但与血栓形成或ACL无关。患者与对照组之间的AT和TPS血浆浓度无差异。使用泼尼松的患者PC、AT和TPS升高（p < 0.01）。天然抗凝剂浓度与血栓形成病史之间无关联。虽然发现FPS降低，但结果表明它似乎不是SLE患者血栓形成的危险因素。由于PC和AT没有降低，它们不应与这些患者的血栓栓塞并发症有关。泼尼松的使用可影响SLE患者天然抗凝剂的浓度。
