Objective To evaluate the clinical value of the adjusted global antiphospholipid syndrome score(aGAPSS)in patients with persistent antiphospholipid antibodies(aPL).Methods The clinical data of patients who were continuously positive for aPL from May 2012 to August 2022 were retrospectively analyzed,except for patients complicated with connective tissue diseases.Demographic data,traditional cardiovascular thrombosis risk factors,aPL profile,and clinical manifestations included and not included in antiphospholipid syndrome(APS)were collected,and aGAPSS was calculated for all patients according to risk indicators and the correlation with clinical manifestation was analyzed through rank sum test.The diagnostic value of aGAPSS for different clinical manifestations was evaluated by the receiver operator characteristic(ROC)curve.Results A total of 67 patients with persistent aPL were enrolled,including 15 patients with persistent extra-criteria positive aPL but did not meet the APS classification criteria and 52 patients with a clear diagnosis of primary APS,of which 20 had a history of thrombosis,36 had a history of pregnancy morbidity,and 24 had extra-criteria clinical manifestations.Patients with history of any thrombosis or arterial thrombosis scored significantly higher than those with no history of thrombosis[any history of thrombosis 11.50(8.25,13.00)vs 8.00(4.00,13.00),Z=2.33,P=0.020;arterial thrombosis history 11.00(9.00,14.00)vs 8.00(4.00,13.00),H=6.21,P=0.043].The aGAPSS score of patients with extra-criteria clinical manifestations was significantly higher than that of patients without corresponding clinical manifestations[13.00(8.25,13.00)vs 8.00(4.00,11.00),Z=2.81,P=0.005],and the aGAPSS score of patients with thrombocytopenia was significantly higher than that of patients without thrombocytopenia[12.50(8.00,13.25)vs 8.00(4.00,13.00),Z=2.23,P=0.026].A subgroup analysis of pregnant women found no statistically significant difference in aGAPSS scores between groups with or without a history of pregnancy morbidity.With thrombosis as the endpoint event,aGAPSS had the highest diagnostic value at 10 points(sensitivity and specificity were 65.00％and 77.78％,respectively).Conclusion In patients with postivity aPL positivity,aGAPSS score is correlated with thrombosis history and extra-criteria clinical manifestations,especially thrombocytopenia.
Antibodies,antiphospholipidAntiphospholipid syndromeAdjusted global antiphospho-lipid syndrome score
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