Koutroubakis I E, Sfiridaki A, Theodoropoulou A, Kouroumalis E A
Department of Gastroenterology, University Hospital Heraklion, Crete, Greece.
Gastroenterology. 2001 Sep;121(3):561-5. doi: 10.1053/gast.2001.27227.
BACKGROUND & AIMS: Hypercoagulable states may play an important role in the pathogenesis of colon ischemia. Aim of this study was to assess this hypothesis investigating the role of acquired and hereditary thrombotic risk factors in patients with definite diagnosis of colon ischemia.
We compared the frequency of antiphospholipid antibodies, protein C, protein S, and antithrombin deficiencies, factor V Leiden, prothrombin gene mutation G20210GA, and methylenetetrahydrofolate reductase C677T in 36 patients (23 men, 13 women; mean age, 64.8 years) with colon ischemia, 18 patients with diverticulitis, and 52 healthy controls.
The prevalence of antiphospholipid antibodies was significantly higher in patients with colon ischemia compared with inflammatory and healthy controls (19.4% vs. 0% and 1.9%). Among genetic factors, only factor V Leiden was significantly associated with colon ischemia (22.2% vs. 0% and 3.8%). A combination of thrombophilic disorders was found in 25% of the cases. Overall, one or several prothrombotic abnormalities were present in 26 patients (72%).
A comprehensive thrombophilic screening in colon ischemia reveals a congenital or acquired thrombophilic state in 72% of patients. Hereditary and acquired thrombotic risk factors may play an important role in the disease pathogenesis.
高凝状态可能在结肠缺血的发病机制中起重要作用。本研究的目的是通过调查获得性和遗传性血栓形成危险因素在确诊为结肠缺血患者中的作用来评估这一假设。
我们比较了36例结肠缺血患者（23例男性，13例女性；平均年龄64.8岁）、18例憩室炎患者和52例健康对照者中抗磷脂抗体、蛋白C、蛋白S和抗凝血酶缺乏、因子V莱顿突变、凝血酶原基因突变G20210GA以及亚甲基四氢叶酸还原酶C677T的发生率。
与炎症对照组和健康对照组相比，结肠缺血患者中抗磷脂抗体的患病率显著更高（19.4%对0%和1.9%）。在遗传因素中，只有因子V莱顿突变与结肠缺血显著相关（22.2%对0%和3.8%）。25%的病例发现存在多种血栓形成倾向障碍。总体而言，26例患者（72%）存在一种或多种促血栓形成异常。
对结肠缺血患者进行全面的血栓形成倾向筛查发现，72%的患者存在先天性或获得性血栓形成倾向状态。遗传性和获得性血栓形成危险因素可能在疾病发病机制中起重要作用。
