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Abstract：
Antiphospholipid Syndrome (APS) is the commonest treatable cause of recurrent miscarriage and pharmacological treatment of pregnant patients with antiphospholipid antibodies (aPL) should aim at preventing obstetric complications and maternal thrombotic events. Conventional treatment for patients with an established diagnosis of obstetric APS (OAPS), generally resulting in over 70-80% successful pregnancies. Since seropositive (SP)-APS and seronegative (SN)-APS patients had shown similar clinical profiles, patients with SN- OAPS, as well as SP-OAPS, should receive combined treatment in order to improve the pregnancy prognosis; indeed, current standard of care increased good pregnancy outcome in SN-APS, with similar effect to confirmed APS. The above data suggest that there are patients with the clinical manifestations of OAPS but persistently negative to conventional aPL that need to be identified to ensure adequate therapy and therefore a better prognosis. The clinical utility of non-criteria aPL in the diagnosis of SN-APS is still a matter of debate. In the last decade more and more studies have reported the presence of patients suffering from SN-APS in which non-conventional (\"non-criteria\") aPL might be present or antibodies may be detected using methodological approaches different from the traditional assays. To improve test standardization large prospective, multicenter, and multinational studies are needed. Therefore, when assessing a patient with clinical manifestations consistent with OAPS but aPL negative using the conventional available assays, the clinician should consider the possibility that the patient is affected with SN-APS.
摘要：
抗磷脂综合征（APS）是复发性流产的最常见可治疗原因，对抗磷脂抗体（aPL）的妊娠患者进行药物治疗应旨在预防产科并发症和母体血栓形成事件。对诊断为产科APS（OAPS）的患者进行常规治疗，通常导致70-80％以上的成功怀孕。由于血清阳性（SP）-APS和血清阴性（SN）-APS患者表现出相似的临床特征，SN-OAPS患者，以及SP-OAPS，应接受综合治疗，以改善妊娠预后；确实，目前的护理标准增加了SN-APS的良好妊娠结局，与确认的APS效果相似。上述数据表明，有些患者具有OAPS的临床表现，但对常规aPL持续阴性，需要进行鉴定以确保适当的治疗并因此获得更好的预后。非标准aPL在SN-APS诊断中的临床实用性仍然存在争议。在过去的十年中，越来越多的研究报道了患有SN-APS的患者的存在，其中可能存在非常规（“非标准”）aPL，或者可以使用不同于传统的方法学方法检测抗体。为了提高测试标准化大的前瞻性，多中心，需要进行跨国研究。因此,当使用常规可用的检测方法评估临床表现与OAPS一致但aPL阴性的患者时，临床医生应考虑患者受到SN-APS影响的可能性.
