Prevalence and Clinical Relevance of Antiphospholipid Antibodies in Ischemic Stroke: A Systematic Review and Meta-Analysis.

However, individual studies have reported conflicting findings regarding the prevalenceof aPL in patients with ischemic stroke and their association with first or recurrent events.

然而，个别研究关于aPL在缺血性中风患者中的患病率以及它们与首次或复发性事件的关联性报告了相互矛盾的结果。

Methods

Systematic searches of PubMed and Embase through May 13, 2025 were conducted to identify case-control, cohort, or cross-sectional studies investigating 3 questions related to aPL seropositivity (defined as positivity for either immunoglobulin G/immunoglobulin M anticardiolipin antibody, immunoglobulin G/immunoglobulin M anti-β2 glycoprotein I antibody, or a lupus anticoagulant): (1) the prevalenceof aPL seropositivity among individuals with ischemic stroke; (2) the association between aPL seropositivity and the risk of first ischemic stroke; and (3) the association between aPL seropositivity and the risk of recurrent ischemic stroke.

通过系统检索PubMed和Embase数据库至2025年5月13日，识别了研究与aPL血清阳性（定义为免疫球蛋白G/免疫球蛋白M抗心磷脂抗体、免疫球蛋白G/免疫球蛋白M抗β2糖蛋白I抗体或狼疮抗凝物任一阳性）相关的三个问题的病例对照、队列或横断面研究：（1）缺血性中风患者中aPL血清阳性的患病率；（2）aPL血清阳性与首次缺血性中风风险的关联；（3）aPL血清阳性与复发性缺血性中风风险的关联。

Random-effects models with inverse weighting were used to calculate pooled prevalences and odds ratios (OR) with 95% CIs.

使用随机效应模型和逆权重计算了汇总的患病率和比值比（OR）及其95%置信区间（CI）。

Risk of bias was assessed using the ROBINS-I tool.

使用ROBINS-I工具评估了偏倚风险。

Results

A total of 52 studies were included (40 case-control, 12 cohort).

共纳入了52项研究（40项病例对照研究，12项队列研究）。

The pooled prevalenceof seropositivity for any aPL among patients with ischemic stroke (51 studies, 9438 patients) was 19.1% (95% CI, 15.4%-23.0%; I2=95.8%). aPL seropositivity was associated with higher odds of first ischemic stroke (43 studies, 19 097 patients; OR, 2.93 [95% CI, 2.31-3.73]; I2=68.7%).

在缺血性中风患者中，任何aPL血清阳性的汇总患病率（51项研究，9438名患者）为19.1%（95% CI, 15.4%-23.0%；I2=95.8%）。aPL血清阳性与首次缺血性中风的较高风险相关（43项研究，19 097名患者；OR, 2.93 [95% CI, 2.31-3.73]；I2=68.7%）。

The strongest associations were for lupus anticoagulant (OR, 6.69 [95% CI, 2.94-15.2]; I2=92.6%) and immunoglobulin G anticardiolipin antibody (OR, 2.56 [95% CI, 1.96-3.35]; I2=92.5%).

最强的关联性是狼疮抗凝物（OR, 6.69 [95% CI, 2.94-15.2]；I2=92.6%）和免疫球蛋白G抗心磷脂抗体（OR, 2.56 [95% CI, 1.96-3.35]；I2=92.5%）。

The odds of recurrent ischemic stroke among patients with versus without any aPL seropositivity were not significantly different (OR, 1.20 [95% CI, 0.87-1.67]; 9 studies, 2873 patients, I2=11.4%).

在有无任何抗磷脂抗体（aPL）血清阳性患者中，复发性缺血性中风的几率没有显著差异（OR，1.20 [95% CI, 0.87-1.67]；9项研究，2873名患者，I2=11.4%）。

Conclusions

Seropositivity for any aPL was present in nearly 1-in-5 patients with ischemic stroke and was associated with increased odds of ischemic stroke at presentation.

近五分之一的缺血性中风患者存在任何抗磷脂抗体（aPL）血清阳性，并且与出现时缺血性中风的几率增加有关。