抗脂抗体和随后的血栓封闭事件在患有缺血性中风的患者
Steven R Levine1, Robin L Brey, Barbara C Tilley
1Department of Neurology, Mt Sinai School of Medicine, New York, NY 10029-6574, USA. steven.levine@mssm.edu
JAMA
|February 6, 2004
概括
抗脂抗体 (aPL) 不能预测缺血性中风患者的复发性血管事件. 不建议对aPL进行查,因为它不会改变对阿司匹林或华法林的治疗反应.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 心血管医学 心血管医学
背景情况:
- 抗脂抗体 (aPL) 与血管封闭事件有关.
- 在缺血事件,特别是复发性中风中,aPL的预测作用仍在争论中.
研究的目的:
- 评估基线aPL阳性是否预测未来的血栓封闭事件.
- 为了确定aPL状态是否影响中风患者对华法林治疗反应与阿司匹林治疗反应.
主要方法:
- 在1770名缺血性中风患者的随机试验 (WARSS) 中进行前性队列研究 (APASS).
- 基线aPL状态 (抗心脂蛋白抗体[aCL],狼抗凝剂抗体[LA]) 在指数中风后90天内进行分析.
- 复合终点的两年随访,包括死亡,缺血性中风和其他血栓封闭性事件.
主要成果:
- 在接受华法林 (RR 0.99) 或阿司匹林 (RR 0.94) 的aPL阳性患者中,没有发现血栓封闭事件的风险增加.
- 在aPL阳性 (22.2%) 和aPL阴性 (21.8%) 患者中,整体事件发生率相似.
- 没有观察到与aPL状态的显著治疗相互作用.
结论:
- 基线aPL阳性并不能预测缺血性中风患者随后的血管事件.
- aPL状态不表明对阿司匹林或华法林治疗的反应差异.
- 在缺血性中风患者中,对aPL的常规查在临床上没有必要.
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