抗磷脂综合征174例临床特点及与欧洲数据的比较分析  

Clinical characteristics of 174 Chinese patients with antiphospholipid syndrome and comparison with European patients

作　　者：陈晓微[1] 申艳[1] 孙传银[1] 杨程德[1] 

机构地区：[1]上海交通大学医学院附属仁济医院风湿免疫科,200001

出　　处：《中华风湿病学杂志》2010年第6期394-397,共4页Chinese Journal of Rheumatology

基　　金：国家自然科学基金（30772009）;上海市重点学科建设项目（07ZZ30）

摘　　要：目的 分析中国人群抗磷脂综合征（AIDS）的临床特点,以提高对这一疾病的认识.方法 回顾性分析1996-2009年在上海仁济医院诊治的APS患者的临床和实验室特点.采用χ2检验.结果 确诊APS 174例,男：女为1：6.6.原发性APS 31例,继发性APS 143例,138例继发于系统性红斑狼疮.141例患者发生血栓事件,以脑梗死、深静脉血栓、肺栓塞为主.62例（44.0%）多部位（≥2处）血栓,45例（31.9%）血栓复发（≥2次）,且原发性APS较继发性APS更易复发血栓（P〈0.05）. 63例发生异常妊娠.7例病理诊断APS肾病（APSN）,以肾小球微血栓为特点.174例AlaS中,抗心磷脂抗体阳性112例（64.4%）,抗β2糖蛋白Ⅰ抗体阳性103例（59.1%）,狼疮抗凝物（LA）阳性50例（28.7%）.结论 APS以血栓事件和异常妊娠为主要表现,本组APS主要血栓事件与欧洲数据组一致;原发性APS更易复发血栓事件;肾小球微血栓为APSN常见病理表现之一;同时进行3种抗磷脂抗体检测有助于临床诊断APS.Objective To analyze the clinical characteristics of antiphospholipid syndrome （APS） in a cohort of Chinese patients. Methods From January 1996 to October 2009, 174 patients with defined APS were retrospectively studied,χ2 test was selected. Results The cohort consisted of 151（86.8%） female and 23 （13.2%） male. Mean age at study was （42±13） years （range： 14-75 years）. Thirty-one （17.8%） patients had primary APS, 143 （82.2% ） patients had APS associated with other diseases, including 138 cases of systemic lupus erythematosus （SLE）. One hundred and forty-one （81.0%） had thrombosis episodes, among which the most common presenting manifestations were stroke （27.6%）, deep venous thrombosis （27.6%） and pulmonary embolism （6.3% ）. Stroke was more prevalent in Chinese than European patients. Forty-five patients （31.9%） had thrombotic recurrences and 62 patients （44.0%） had more than two sites of thrombosis. Patients with primary APS had higher rates of rethrombosis than those with secondary APS （P〈0.05）. Fetal morbidity rate of 126 married women in our study was 50.0%. Seven of APS patients with APS nephropathy were characterized by thrombotic microangiopathy. The presence of anticardiolipin antibodies was detected in 112 patients （64.4% ）, anti-beta-2 glycoprotein Ⅰ antibodies in 103 patients （59.1%） and lupus anticoagulant in 50 patients （28.7%）. Conclusion APS is characterized by recurrent thrombosis, pregnancy morbidity and positive antiphospholipid antibodies tests. Stroke, deep venous thrombosis and pulmonary embolism are the most common manifestations both in Chinese and European patients. Rethrombosis is more prominent in primary APS. Thrombotic microangiopathy is one of the most common histological changes of APS nephropathy. Multiple tests for aPL are proposed.

关 键 词：抗磷脂综合征 血栓形成 抗体 抗磷脂 

分 类 号：R593.2[医药卫生—内科学]