抗磷脂症候群與懷孕

Antiphospholipid Syndrome and Pregnancy

杜昀真(Yun-Chen Toh)

《內科學誌》 30卷4期 (2019/08) Pp. 264-272

https://doi.org/10.6314/JIMT.201908_30(4).05

摘要

抗磷脂症候群（antiphospholipid syndrome, APS）是一免疫造成的血栓相關疾病，可同時影響任何組織或器官的動靜脈循環。另一個抗磷脂症候群臨床表現是在產科方面。其中包括一或多次懷孕10週或10週以上不明原因正常胎兒之死胎、34週內因子癲症或嚴重之子癲前症造成正常胎兒之早產、3次或更多次10週以內不明原因之自然流產。目前抗磷脂症候群之診斷標準是根據2006年的抗磷脂症候群分類標準修訂版（revised Sapporo APS Classification Criteria）（也稱為Sydney criteria）。目前治療的共識是對於有血栓症狀的病患投以長期口服抗凝血治療，在孕期有產科併發症者則使用阿斯匹林（aspirin）和肝素（heparin）。在此我們回顧抗磷脂症候群與懷孕相關疾病最新的文獻，使內科醫師能夠更加了解此疾病，希望對於日後診斷抗磷脂症候群及其治療上能有所幫助。

關鍵字

抗磷脂症候群（Antiphospholipid syndrome, APS） ； 抗磷脂抗體（Antiphospholipid antibody, aPL） ； 產科併發症（Obstetric morbidity）

並列摘要

Antiphospholipid syndrome is an autoimmune disease which can cause prothrombotic disorder and can affect both the venous and arterial circulation in any tissue or organ. Another clinical manifestations of the antiphospholipid syndrome are obstetrical. They include the unexplained death of one or more morphologically normal fetuses at or beyond the 10^(th) week of gestation, the premature birth of one or more morphologically normal neonates before the 34^(th) week of gestation because of either eclampsia or severe preeclampsia, and three or more unexplained, spontaneous abortion before the 10^(th) week of gestation. Currently, the diagnosis of antiphospholipid syndrome is according to 2006 revised Sapporo Classification Antiphospholipid syndrome Criteria (also known as the Sydney Classification Criteria). The consensus is to treat those who develop thrombosis with long-term oral anticoagulation therapy and to prevent obstetric manifestations by use of aspirin and heparin. In this article, we review recent advances in antiphospholipid syndrome and allow clinical physicians to further understand the disease. This may help clinical physicians to make correct diagnosis and appropriate treatments.