系统性红斑狼疮继发抗磷脂抗体综合征临床分析  

Clinical analysis of systemic lupus erythematosus complicated with antiphospholipid syndrome

作　　者：金莉[1] 马艳[1] 李向培[1] 厉小梅[1] 吴竞生 汪国生[1] 陶金辉[1] 钱龙[1] 

机构地区：[1]安徽省立医院风湿免疫科,安徽合肥230001 [2]安徽省立医院血液科,安徽合肥230001

出　　处：《诊断学理论与实践》2014年第3期242-245,共4页Journal of Diagnostics Concepts & Practice

摘　　要：目的:探讨系统性红斑狼疮(system ic lupus erythematosus,SLE)继发抗磷脂抗体综合征(antiphospholipid syndrome,APS)的临床特点、实验室指标及相关因素,以早期发现继发性APS。方法:回顾性分析2005年1月至2014年1月收集的129例SLE和APS患者的临床资料,包括临床表现、妊娠情况、抗核抗体、抗心磷脂抗体等。结果:129例患者中,原发性APS(primary antiphospholipid syndrome,PAPS)8例;SLE者121例,其中SLE合并APS患者(SLE-APS)41例,仅诊断为SLE患者(SLE-APA-)40例及出现抗磷脂抗体(antiphospholipid antibody,APA)异常但APS诊断依据不足(SLE-APA+)的SLE患者40例。8例原发性APS患者中,3例男性均表现为下肢深静脉血栓形成及手微动脉血栓形成,有婚育史的女性患者中5例均有病态妊娠表现,自发性流产和(或)死胎,其中2例有肺栓塞、门(脾)静脉栓塞。41例SLE-APS患者中,表现为下肢深静脉血栓有15例,肺栓塞患者3例,脑梗死10例;SLE-APS组抗β2-糖蛋白1(抗β2-GP-1)浓度明显高于SLE-APA+组及SLE-APA-组,而血小板计数明显减低。结论:SLE合并APS患者的血清中存在高浓度抗β2-GP-1,提示高浓度抗β2-GP-1是SLE继发APS的独立危险因素。Objective To investigate the occurrence, clinical characteristics and laboratory index of systemic lupus erythematosus （SLE） with secondary antiphospholipid syndrome（APS）. Methods One hundred and twenty-nine patients with SLE and APS from Jan 2005 to Jan 2014 were enrolled. Data from patients including clinical manifestations, pregnancy, anti-nuclear antibody and anti-cardiolipin antibody were analyzed retrospectively. Results Among the 129 patients,8 patients had primary APS, 41 patients had systemic lupus erythematosus complicated with antiphospholipid syndrome （SLE-APS）, 40 patients had SLE only （SLE-APA-）, and 40 patients had SLE with abnormally positive APA, yet the diagnosis of APS was not definite （SLE-APA＋）. For 8 patients with APS, 3 male patients had lower limb deep venous thrombus and micro-artery-thrombosis of hand, and the other 5 female patients had abnormal pregnancy （spontaneous abortion or dead fetus）. Two of the 5 female had pulmonary thrombus and spleen/ portal vein embolization. Of the 41 cases with SLE-APS, 15cases had lower limb deep venous thrombus, 10 cases had cerebral infarction, and 3 patients had pulmonary thrombus. Serum level of anti-β2-GP-1 was significantly higher in SLE-APS group than that in SLE-APA~ and SLE-APA-groups, while platelet count was significantly lower. Conclusions High serum level of anti-β2-GP-1 is seen in patient with SLE complicated with APS, high anti-β2-GP-1 may be an independent risk factor for the development of secondary APS.

关 键 词：红斑狼疮 系统性 抗磷脂抗体综合征 血栓形成 

分 类 号：R593.2[医药卫生—内科学]