北京大学学报(医学版)2024,Vol.56Issue(6) :1036-1040.DOI:10.19723/j.issn.1671-167X.2024.06.014

抗磷脂抗体在白塞病合并血栓中的临床意义

Clinical significance of antiphospholipid antibodies in Behcet disease with thrombosis

李钰锴 王红彦 罗靓 李云 李春
北京大学学报(医学版)2024,Vol.56Issue(6) :1036-1040.DOI:10.19723/j.issn.1671-167X.2024.06.014

抗磷脂抗体在白塞病合并血栓中的临床意义

Clinical significance of antiphospholipid antibodies in Behcet disease with thrombosis

李钰锴 1王红彦 1罗靓 2李云 1李春1
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作者信息

  • 1. 北京大学人民医院风湿免疫科,北京 100044
  • 2. 北京大学人民医院风湿免疫科,北京 100044;重庆市渝北区人民医院中医科,重庆 401120
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摘要

目的:探讨抗磷脂抗体(antiphospholipid antibody,aPL)在白塞病(Behcet disease,BD)合并血栓中的分布及其临床意义.方法:回顾性选取2008年2月至2024年7月于北京大学人民医院风湿免疫科住院的222例BD患者作为研究对象,收集患者的一般资料(包括年龄、性别等)、临床表现(包括口腔溃疡、生殖器溃疡和血栓等)、实验室指标[包括aPL、人类白细胞抗原(human leukocyte antigen,HLA)-B51、抗内皮细胞抗体等],随访合并血栓的BD患者血栓复发情况.使用卡方检验比较aPL阳性组和aPL阴性组患者的临床症状及实验室指标上的差异.使用Log-rank检验对aPL阳性组和aPL阴性组的血栓复发率进行比较,并用Two-stage方法进行P矫正,最后使用Graphpad prism进行绘图.结果:BD患者中,aPL单阳性、双阳性及三阳性患者的比例分别为22.1%、0.5%和1.4%.抗心磷脂抗体、抗β2糖蛋白Ⅰ抗体和狼疮抗凝物(lupus anticoagulant,LAC)的阳性率分别为10.4%、1.8%和13.1%.aPL阳性组血栓的发生率显著高于aPL阴性组(44.9%vs.16.9%,P<0.001).aPL阳性组的血红细胞沉降率[(20.78±4.91)mm/h vs.(15.85±4.29)mm/h,P=0.005]、C 反应蛋白[(12.97±5.17)mg/L vs.(7.49±4.22)mg/L,P=0.010]和免疫球蛋白 M[(1.55±0.95)g/L vs.(1.12±0.72)g/L,P<0.001]显著高于aPL阴性组.LAC阳性是BD患者血栓发生的独立危险因素(OR=8.51,95%CI:2.71~26.72,P<0.001).aPL阳性组的血栓复发率高于aPL阴性组,但两组差异无统计学意义(69.23%vs.52.17%,P=0.932).结论:LAC阳性和动脉瘤是BD患者血栓形成的独立危险因素,aPL阳性也会显著增加BD患者血栓发生风险,对指导BD的治疗具有重要意义.

Abstract

Objective:To investigate the distribution and clinical significance of antiphospholipid anti-body(aPL)in patients with Behcet disease(BD).Methods:A total of 222 BD patients admitted to the Department of Rheumatology and Immunology in Peking University People's Hospital from February 2008 to July 2024 were selected retrospectively.General data of the patients including age and gender were collec-ted.Clinical manifestations(including oral ulcers,genital ulcers,and thrombosis)and laboratory indexes(including aPL,human leukocyte antigen-B51,and anti-endothelial cell antibody)were collec-ted.The recurrence of thrombosis in the BD patients with thrombosis was followed up.Chi-square test was used to compare the clinical symptoms and laboratory indicators between aPL positive group and aPL negative group.Log-rank test was used to compare the recurrence rates of the aPL positive group and the aPL negative group,and P correction was performed by Two-stage method.Finally,Graphpad prism was used for plotting.Results:The prevalence of single aPL,double aPL and triple aPL positivity in the BD patients were 22.1%,0.5%and 1.4%,respectively.The positive rates of anti-cardiolipin antibody,anti-β2 glycoprotein Ⅰ antibody and lupus anticoagulant(LAC)were 10.4%,1.8%and 13.1%,re-spectively.The incidence of thrombosis in the aPL positive group was significantly higher than that in the aPL negative group(44.9%vs.16.9%,P<0.001).The erythrocyte sedimentation rate[(20.78±4.91)mm/h vs.(15.85±4.29)mm/h,P=0.005],C-reactive protein[(12.97±5.17)mg/L vs.(7.49±4.22)mg/L,P=0.010]and IgM[(1.55±0.95)g/L vs.(1.12±0.72)g/L,P<0.001]in the aPL positive group were significantly higher than those in the aPL negative group.LAC positivity was an independent risk factor for thrombosis in the BD patients(OR=8.51,95%CI:2.71-26.72,P<0.001).The recurrence rate of the aPL positive group was higher than that of the aPL negative group,but there was no statistical difference(69.23%vs.52.17%,P=0.932).Conclusion:Positive LAC and aneurysm are independent risk factors for thrombosis in BD patients.At the same time,positive antiphos-pholipid antibody can also significantly increase the risk of thrombosis in BD patients,which has impor-tant significance for guiding the treatment of BD.

关键词

抗磷脂抗体/白塞病/血栓/复发/危险因素

Key words

Antiphospholipid antibody/Behcet disease/Thrombosis/Recurrence/Risk factors

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出版年

2024
北京大学学报(医学版)
北京大学

北京大学学报(医学版)

CSTPCD北大核心
影响因子:1.681
ISSN:1671-167X
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