抗リン脂質抗体症候群（APS）患者の臨床的特徴と治療状況

To investigate and analyze the clinical behavior and therapeutic status of patients with antiphospholipid syndrome (APS).

Patients diagnosed with APS between September 2021 and October 2025 were enrolled in this investigation. Data collection included: demographic characteristics, disease duration, initial presenting symptoms, departments of first visit and diagnosis, time of the first visit and definite diagnosis, the interval of follow-up, previous and current medications. Assessments using the 36-item short form health survey (SF-36), hospital anxiety and depression scale (HADS), and general medication adherence scale (GMAS) were also conducted. Age- and gender-matched healthy controls were selected and completed parallel SF-36 and HADS evaluations during the same period.

In the study, 196 patients with APS were investigated. The median age of onset was 36 years, the male to female ratio was 1:6.8, and median disease duration was 3.0 years. Rheumatology & Immunology was the most common department for the first hospital visit (33.2%, 65/196), followed by Hematology (21.9%) and Reproductive Endocrinology and Infertility Center (18.4%). Other departments included Neurology (5.6%), Vascular Surgery (5.1%), and Emergency (4.1%). The median time from symptom onset to APS diagnosis was 6.0 months, with 32.1%(63/196) of patients experiencing a diagnostic delay of over one year. Regarding follow-up adherence, 56.6% (111/196) of patients with APS maintained regular follow-ups at intervals of ≤3 months, while 7.1% (14/196) of the patients visited their doctor less than once a year. The primary pharmacological treatments for the APS patients included hydroxychloroquine, warfarin and other anticoagulants, and antiplatelet agents. According to the GMAS assessment, 76.1% of the patients demonstrated high or good medication adhe-rence. Among all SF-36 domains, the scores of general health (GH) in the APS patients were significantly lower compared with healthy controls (P < 0.05). According to the HADS, the proportion of anxiety symptoms was significantly higher in the APS patients compared with healthy controls (13.8% vs. 6.7%, P < 0.05).

In this study, delayed diagnosis in APS remained prevalent. Compared with healthy controls, the APS patients exhibited significantly impaired physical function and elevated anxiety symptoms. Regular follow-up monitoring should be emphasized, and greater attention must be paid to psychoeducational interventions.