狼疮抗凝患者血栓形成的评价

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2025-09-09 DOI:10.1016/j.thromres.2025.109474

Elena Pontara , Maria Grazia Cattini , Elisa Bison , Marta Tonello , Margherita Zen , Cristina Vicenzetto , Andrea Giordani , Anna Baritussio , Alida L.P. Caforio , Vittorio Pengo

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引用次数: 0

摘要

研究发现，三阳性抗磷脂综合征（aPS）患者的抗磷脂酰丝氨酸/凝血酶原抗体（aPS/PT）、狼疮抗凝剂（LA）效价和血栓形成密切相关（LA+/抗心磷脂- acl +/a - β2-糖蛋白i -a - β 2gpi +）通过活化蛋白C抵抗（aPC-R）检测。这种相互依赖是否存在于孤立性LA患者中尚不清楚。目的本横断研究评估孤立LA患者aPS/PT和aPC-R与凝血抑制剂诊断的关系。方法采用稀释后的罗素蝰蛇毒液时间（dRVVT）和二氧化硅凝血时间（SCT）测定血清sla。ELISA法检测IgG、IgM、α - β 2gpi和aPS/PT。凝血酶生成法测定APC-R。结果分离性LA （LA+/aCL-/a - β 2gpi -）患者32例，三阳性LA+/aCL+/a - β 2gpi +患者53例，对照组24例。与三阳性患者相比，LA患者的总（IgG + IgM） aPS/PT抗体滴度较低，aPC-R较弱。当通过凝血试验（dRVVT和SCT）同时诊断分离性LA时，总aPS/PT滴度高于通过单一阳性试验（dRVVT或SCT）诊断分离性LA时，aPC-R更强。仅SCT阳性患者（dRVVT-、SCT+）的总aPS/PT和aPC-R与对照组相似。结论LA、aPS/PT和aPC-R与凝血抑制剂的诊断方法有关。这些数据可能对临床医生解释孤立性LA的临床价值有用。

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Assessment of thrombophilia in patients with lupus anticoagulant

Background

A close link between anti phosphatidyl-serine/prothrombin antibodies (aPS/PT), Lupus Anticoagulant (LA) potency and thrombophilia detected by activated protein C Resistance (aPC-R) in triple-positive antiphospholipid syndrome (APS) patients (LA+/anticardiolipin-aCL+/aβ2-Glycoprotein I-aβ2GPI+) has been observed. Whether this interdependence is present in patients with isolated LA is not known.

Objectives

This cross-sectional study evaluates aPS/PT and aPC-R in isolated LA patients in relation on how the diagnosis of the coagulation inhibitor was made.

Methods

LA was determined using the diluted Russell Viper Venom Time (dRVVT) and the Silica Clotting Time (SCT). IgG and IgM aCL, aβ2GPI and aPS/PT were measured by ELISA. APC-R was determined by thrombin generation assay.

Results

We studied 32 patients with isolated LA (LA+/aCL-/aβ2GPI-), 53 triple positive patients (LA+/aCL+/aβ2GPI+) and 24 controls. Total (IgG + IgM) aPS/PT antibody titer was lower and aPC-R weaker in isolated LA compared to triple-positive patients. When isolated LA was diagnosed by both coagulation positive tests (dRVVT and SCT), total aPS/PT titers were higher and aPC-R stronger than when isolated LA was diagnosed by a single positive test (either dRVVT or SCT). Total aPS/PT and aPC-R in patients positive for SCT only (dRVVT-, SCT+), were like those of control subjects.

Conclusions

The relation between LA, aPS/PT and aPC-R is linked to the way the coagulation inhibitor is diagnosed. These data may be useful to clinicians when interpreting the clinical value of isolated LA.

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来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.