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Thrombotic risk assessment in antiphospholipid syndrome: the role of new antibody specificities and thrombin generation assay

机译:抗磷脂综合征的血栓风险评估:新抗体特异性和凝血酶生成测定的作用

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摘要

Antiphospholipid syndrome (APS) is an autoimmune condition characterized by the presence of antiphospholipid antibodies (aPL) in subjects presenting with thrombosis and/or pregnancy loss. The currently used classification criteria were updated in the international consensus held in Sidney in 2005. Vascular events seem to result of local procoagulative alterations upon triggers influence (the so called “second-hit theory”), while placental thrombosis and complement activation seem to lead to pregnancy morbidity. The laboratory tests suggested by the current classification criteria include lupus anticoagulant, a functional coagulation assay, and anticardiolipin and anti-β2-glycoprotein-I antibodies, generally detected by solid phase enzyme-linked immunosorbent assay. The real challenge for treating physicians is understanding what is the actual weight of aPL in provoking clinical manifestations in each case. As thrombosis has a multi-factorial cause, each patient needs a risk-stratified approach. In this review we discuss the role of thrombotic risk assessment in primary and secondary prevention of venous and arterial thromboembolic disease in patients with APS, focusing on new antibody specificities, available risk scoring models and new coagulation assays.
机译:抗磷脂综合征(APS)是一种自身免疫性疾病,其特征在于存在血栓形成和/或妊娠流失的受试者中存在抗磷脂抗体(aPL)。当前使用的分类标准已在2005年在悉尼举行的国际共识中得到了更新。血管事件似乎是由触发因素影响引起的局部促凝改变(所谓的“二次打击理论”),而胎盘血栓形成和补体激活似乎导致了这种情况。到妊娠发病。当前分类标准建议的实验室测试包括狼疮抗凝剂,功能性凝血分析以及抗心磷脂和抗β2-糖蛋白-I抗体,通常通过固相酶联免疫吸附法进行检测。治疗医师的真正挑战是了解每种情况下aPL引起临床表现的实际重量是多少。由于血栓形成有多种原因,因此每个患者都需要采取风险分层的方法。在这篇综述中,我们讨论了血栓形成风险评估在APS患者静脉和动脉血栓栓塞性疾病的一级和二级预防中的作用,重点是新的抗体特异性,可用的风险评分模型和新的凝血测定。

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