抗磷脂血栓综合征与获得性抗活化的影响C现象

了解抗磷脂抗体（ＡＰＡ）,抗活性化的蛋白Ｃ（ＡＰＣＲ）与抗磷脂血栓综合征（ＡＰＬ－Ｔ）的关系,进一步探讨ＡＰＬ－Ｔ血栓发生机制。方法以ＥＬＩＳＡ检测ＡＣＡ（ＩｇＭ,ＩｇＡ）;ＡＰＴＴ检测ＬＡ;ＡＰＴＴ＋／－ＡＰＣ检测ＡＰＣＲ。结果２０例患者符合ＡＰＬ－Ｔ诊断。根据病因分类,１００例ＳＬＥ患者中１４例为继发性ＡＰＬ－６：１６例“原因不明”血栓与习惯性流产患者中６例为原发性ＡＰＬ－Ｔ。根据抗体分类,２

Antiphospholipid thrombosis syndrome and acquired activated protein C resistance

OBJECTIVE: To explore the correlation between antiphospholipid antibodies (APA) activated protein C resistance (APCR) and antiphospholipid thrombosis (APL-T) syndrome and investigate the mechanism of thrombosis in APL-T syndrome. METHODS: ELISA, APTT-LA and APTT+/-APC methods were used to detect anticardiolipin antibodies (ACA), lupus anticoagulants (LA) and APCR in 20 APL-T syndrome patients respectively. RESULTS: Twenty patients were diagnosed as APL-T. The patients were classified in three ways. According to etiology, 14 of 100 systemic lupus erythematosus (SLE) patients were diagnosed as "secondary" APL-T, and 6 of 16 "unexplained" thrombosis and spontaneous abortion as "Primary" APL-T syndrome. According to antibodies, 12 of 20 patients with positive LA were diagnosed as lupus anticoagulant thrombosis syndrome (LA-T), 12 of 20 patients with positive ACA as anticardiolipin antibodies thrombosis syndrome (ACA-T). According to clinical presentation: 7 of 20 patients with deep vein thrombosis were classified as type I APL-T, 3 of 20 patients with cerebrovascular thrombosis as type II, 1 of 20 patients with vein cerebrovascular thrombosis and spontaneous abortion as type IV (mixing), and 9 of 20 patients with spontaneous abortion as type V (fetal wastage type). The ACAs and LA are strongly associated with APL-T. There is close relationship between APCR and APL-T. CONCLUSION: The acquired APCR might be an important reason for thrombosis in APL-T caused by APA and LA.