初级抗脂综合征中的心脏膜疾病
Stanley Niznik1, Micha J Rapoport2,3, Orly Avnery3,4
1Clinical Immunology, Angioedema and Allergy Institute, The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel.
Rheumatology (Oxford, England)
|August 12, 2023
概括
患有原发性抗脂综合征 (pAPS) 和心脏膜疾病 (HVD) 的患者表现出更严重的临床过程,包括增加的血栓事件和特定抗体概况. 这表明pAPS-HVD是一个高风险子组,需要密切监测.
科学领域:
- 类风湿病学 类风湿病学
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
背景情况:
- 抗脂综合征 (APS) 是一种自身免疫性疾病,与血栓形成和妊娠并发症的风险增加有关.
- 心脏膜疾病 (HVD) 是已知的APS并发症,但影响其在初级APS (pAPS) 患者的临床参数并不明确.
研究的目的:
- 调查与心脏膜疾病相关的初级APS患者 (pAPS-HVD) 的临床特征和结果.
- 在pAPS患者中确定与HVD相关的临床参数和血清学标记.
主要方法:
- 一个多中心的回顾性研究,将33名pAPS患者与HVD (pAPS-HVD组) 与128名没有HVD的pAPS患者 (pAPS-对照组) 进行比较.
- 分析了临床数据,包括血栓事件,活体视网膜,以及需要先进疗法.
- 评估了血清学概况,包括抗心脂蛋白IgG,抗β2-糖蛋白1IgG和抗脂抗体 (aPL) 三重阳性.
主要成果:
- 与对照组相比,pAPS-HVD患者的脑血管事件 (56.3%与25%相比) 和活体视网膜病 (24.2%与7.8%) 显著增加.
- 在pAPS-HVD组中,灾难性APS (CAPS),复发性血栓形成 (33.3%对4.7%) 和需要先进治疗的情况更为频繁.
- 特定抗体配置文件,包括抗β2-糖蛋白1IgG (84.8%与63.2%相比),抗心脂蛋白IgG (90.9%与64.8%相比) 和三倍的aPL阳性 (75.8%与56.5%相比),在pAPS-HVD患者中更常见.
结论:
- 患有心病的初级APS患者表现出更严重的临床表型,其特征是血栓事件增加和特定的血清学标记.
- 在pAPS患者中存在HVD,确定了一个高风险子组,需要加强管理和监测.
- 在pAPS-HVD患者的门手术与男性性别,吸烟,动脉四肢缺血症和活体视网膜症有关.
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