抗磷脂血栓综合征

目的:了解抗磷脂抗体(APA)与抗磷脂血栓综合征(APL-T)相关性,进一步探讨APL-T血栓发生机制。方法:采用 ELISA检测ACA(IgG,M,A),PTT-LA检测LA,APTT /-APC检测APC-R。结果:20例患者符合 APL-T诊断。根据病因分类:14/100例SLE为继发性 APL-T;6/16例“原因不明”血栓与习惯性流产为原发性APL-T。根据抗体分类:12/20例LA阳性为狼疮抗凝因子血栓综合征(LA-T);12/20例ACA阳性为抗心磷脂抗体血栓综合征(ACA-T)。根据临床症状分类:7/20例静脉血栓为Ⅰ型,3/20例脑梗塞为Ⅱ型;1/20例静脉血栓合并脑梗塞,习惯性流产为Ⅳ型(混全型);9/20例习惯性流产为Ⅴ型APL-T。APL-T患者LA阳性率(12/20,60％)明显高于正常对照组(NC组0/20,0%)。患者ACA-IgG,M与NC组比较有显著性差异(P<0.05);APCR在APL-T患者中阳性率(14/20,70％)明显高于NC组(l/20,5％);LA阳性组中的APCR阳性率(10/11,90.9％)明显高于LA阴性组(l/11,9％),ACA阳性组的APCR阳性率(7/11,63.3％)与ACA阴性组(4/11,36.36％)比较有显著性差异。结论:APA与APCR密切相关,APL-T中血栓发生率与APA以及APCR存在明显相关性,说明APA对PC途径的抑制引起获得性APCR可能是APL-T血栓发生的重要原因,故可将APA作为血栓危险性增加的标志物。

Antiphospholipid Thrombosis Syndrome

Objective:To explore the correlation between Antiphospholipid antibodies (APA) and antiphospho-lipid thrombosis ( APL - T) syndrome, and further investigate the occurring mechanism of thrombosis in APL -T syndrome. Method:ELISA, PIT - LA and APTT / - APC methods were used respectively to detect anti-cardiolipin antibodies (ACA), lupus anticoagulants (LA) and APC R in 20 APL - T syndrome patients. Results: 20 patients were diagnosed as APL - T and classified in three ways. According to the etiology, 14/100 SLE were diagnosed as 'secondary" APL - T, and 6/16 "unexplained thrombosis and pregnancy losses as "Primary" APL- T syndrome. According to the antibodies, 12/20 patients with LA positive were diagnosed as Lupus Anticoagulant Thrombosis Syndrome (LA - T), 12/20 patients with ACA positive as Anticardiolipin Thrombosis Syndrome (ACA - T) . According to clinical presentation: 7/20 patients with deep vein thrombosis were classified as type I APL- T, 3/20 patients with cerebrovascular thrombosis as type II, 1/20 patients with vein, cerebrovascular thrombosis and fetal wastage as type IV (Mixing), 9/20 patients with pregnancy loss as type V (fetal wastage type). The ACA- IgG, M and LA are strongly associated with APL- T. There is certain relationship between APCR and APL- T. Conclusion: APA is strongly associated with APCR, The occuring of thrombosis in APL - T is It is proposed that the acquired ARC R inducing by APA is the important reason for thrombosis in APL - T.