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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Spectrum of Antiphospholipid Antibodies (aPL) in Patients With Cerebrovascular Disease
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Spectrum of Antiphospholipid Antibodies (aPL) in Patients With Cerebrovascular Disease

机译：脑血管病患者的抗磷脂抗体（APL）的光谱

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Background: The association of stroke and antiphospholipid antibodies (aPL) other than anticardiolipin antibodies (aCL) is not well documented. Objective: To report the distribution of aCL, antiphosphatidylethanolamine (aPE), and antiphosphatidylserine (aPS) aPL among patients with symptomatic cerebrovascular disease evaluated by our Stroke Service at Indiana University Hospital from January 1997 to November 1999. Methods: We retrospectively reviewed medical records from 1997 to 1999 at Indiana University Hospital for all patients with symptomatic cerebrovascular disease using the International Statistical Classification of Diseases, 9th Revision, (ICD-9) codes. We identified patients with elevated titers of aPL. Sera from these patients were obtained within the first 30 days of the index event. We included only those patients for whom the serum samples were tested in a single laboratory by an in-house enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G (IgG) immunoglobulin A (IgA) and immunoglobulin M (IgM) aCL, aPE, and aPS. We examined the clinical presentation, stroke risk factors, associated rheumatologic disorders, and distribution of aPL specificity and isotype. Results: Thirty-four of 185 patients, 26 women (76%), with a mean age of 46 years, and 8 men (24%) with a mean age of 46 years, had aPL. Nine patients had transient ischemic attacks (TIA), 25 suffered strokes, 23 had ischemic infarcts, and 2 had hemorrhagic infarcts (1 had a superior sagittal sinus thrombosis with bilateral hemispheric hemorrhagic infarcts, and one had bilateral hemorrhagic infarcts associated with systemic lupus erythematosus [SLE]). Six patients had SLE. The most common stroke risk factors were cigarette smoking (38%) and arterial hypertension (26%). Approximately two thirds (60%) of patients had a single positive aPL finding: aPE in 35%, aCL in 18%, and aPS in 6%. Multiple specificities were seen in 40%. IgA was the only aPL antibody isotype detected in 26% of the patients, IgG was the lone isotype in 24%, and IgM alone in 12%. Multiple aPL isotypes were detected in 38% of patients. Five patients (15%) presented with aPE IgA as the exclusive aPL. Conclusion: In our series, aPE was the most frequent finding in stroke patients who were suspected to have an associated aPL syndrome. These specific types of aPL may be present relatively often in stroke patients and are often not assessed. Further studies are needed to determine how specific these aPL are in stroke versus other acute illnesses and versus healthy controls, and how these aPL are associated with stroke risk.
机译：背景：除抗野生脂素抗体（ACL）以外的卒中和抗磷脂抗体（APL）的缔合品并未充分记录。目的：报告1997年1月至1999年11月在印第安纳大学医院中卒中服务评估的症状脑血管疾病患者ACL，抗磷脂酰乙胺胺（APE）和抗磷脂酰胺（APS）APL的分布。方法：我们回顾性地审查了医疗记录1997年至1999年印第安纳大学医院为所有患有症状脑血管疾病的患者使用国际统计分类，第9次修订，（ICD-9）代码。我们确定了APL滴度升高的患者。来自这些患者的血清在指数事件的前30天内获得。我们只包括那些通过内部酶联免疫吸附测定（ELISA）在单一实验室中测试血清样品的那些患者，用于免疫球蛋白G（IgG）免疫球蛋白A（IgA）和免疫球蛋白M（IgM）ACL，APE，和aps。我们检查了临床介绍，中风危险因素，相关的风湿病病症和APL特异性和同种型的分布。结果：185名患者中有34名，26名女性（76％），平均年龄为46岁，8名男子（24％），平均年龄为46岁，拥有APL。九个患者发生了短暂的缺血性发作（TIA），25例患有令人患，23例缺血性梗死，2例出血性梗死（1具有双侧半球出血性梗死的血液血栓形成，并且一个与Systemic Lupus红斑狼疮有关的双侧出血梗塞[ SLE]）。六名患者没有SLE。最常见的卒中危险因素是吸烟（38％）和动脉高血压（26％）。大约三分之二（60％）患者有一个阳性APL发现：猿35％，APL为18％，APS为6％。在40％中看到多种比例。 IgA是在26％的患者中检测到的唯一APL抗体同种型，IgG是24％的孤单型，而IgM单独为12％。在38％的患者中检测到多个APL同学。五名患者（15％）用APE IGA呈现为独家APL。结论：在我们的系列中，APE是患有相关APL综合征的中风患者中最常见的发现。这些特定类型的APL可以相对常见于中风患者，并且通常不会评估。需要进一步的研究来确定这些APL如何与其他急性疾病和与健康控制相比，以及这些APL如何与行程风险相关联。

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