可怕的APS - 一种新定义的严重APS的变体
Stanley Niznik1, Tania Zaher1,2, Soad Haj Yehia1,3
1Clinical Immunology, Angioedema and Allergy Unit, Sheba Medical Center, Ramat Gan, Israel.
Frontiers in immunology
|January 23, 2026
概括
研究人员确定了一种新的抗脂综合征 (APS) 的子类别,称为可怕的APS (TrAPS),尽管服用抗凝药,但其特点是复发性血栓形成. 一个新的评分系统,TrAPScore,有助于识别患有这种严重的耐火性疾病的患者.
科学领域:
- 类风湿病学 类风湿病学
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
背景情况:
- 抗脂综合征 (APS) 有不同的临床表现.
- 一些APS患者患有严重的耐火性疾病,不符合灾难性APS (cAPS) 标准.
研究的目的:
- 定义和描述一个新的APS子类别,称为可怕的APS (TrAPS).
- 开发一个预测得分 (TrAPScore) 来识别TrAPS患者.
主要方法:
- 对306名初级APS患者的分析,不包括产科,非标准APS或cAPS.
- TrAPS定义: >2突破性血栓事件尽管抗凝药或需要免疫调节/手术.
- 多变量分析以确定TrAPScore的预测因素.
主要成果:
- 在209名血栓性初级APS患者中,有27名 (12.7%) 符合TrAPS标准.
- 在TrAPS患者中,有较高的静脉血栓形成,微血管干扰,心脏膜疾病,血栓缩和三重阳性抗体的发生率.
- TrAPS与增加的死亡率 (18.5%对5.1%) 和抗凝固剂耐药性 (81.4%) 有关.
- TrAPScore预测因素:严重的血小板缺血,心脏膜疾病,微血管表现,三重阳性血清学.
- 对于TrAPS,TrAPS得分>6显示高的PPV (78%-82.5%);得分<4显示高的NPV (96.9%).
结论:
- 可怕的APS (TrAPS) 是APS的一个独特的耐火子类别.
- 根据关键的临床和血清学因素,TrAPScore有效地识别了患有严重,耐火性疾病的患者.
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