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  • 作者: Zuo Yu Shi Hui Li Chun Knight Jason S.
  • 学科: 医药卫生 >
  • 创建时间:2020-08-10
  • 出处:《中华医学杂志(英文版)》 2020年第08期
  • 机构:Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA,Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China,Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing 100044, China
  • 简介:AbstractAntiphospholipid syndrome (APS) is a thromboinflammatory disease with a variety of clinical phenotypes. Primary thrombosis prophylaxis should take an individualized risk stratification approach. Moderate-intensity vitamin K antagonist such as warfarin remains the primary strategy for secondary thrombosis prophylaxis among APS patients, especially for patients with predominantly venous disease. For now, direct oral anti-coagulants should be avoided in most APS patients, especially those with history of arterial manifestations. Obstetric APS management should be tailored based on an individual patient’s antiphospholipid antibody profile, and obstetric and thrombotic history. Pharmacological agents beyond anticoagulants may be considered for the management of microthrombotic and nonthrombotic manifestations of APS, although more data are needed. A relatively recent discovery in the area of APS pathogenesis is the implication of neutrophil extracellular traps in thrombin generation and initiation of inflammatory cascades. APS is a complex thromboinflammatory disease with a broad clinical spectrum. Personalized therapy according to an individual’s unique thrombosis and obstetric risk should be advocated.

  • 标签: Antiphospholipid syndrome Antiphospholipid antibodies Treatment