视网膜中央静脉阻塞患者的血栓形成风险因素。

Thrombophilic risk factors in patients with central retinal vein occlusion.

作者信息

Marcucci R, Bertini L, Giusti B, Brunelli T, Fedi S, Cellai A P, Poli D, Pepe G, Abbate R, Prisco D

机构信息

Dept Area Critica Medico-Chirurgica, Thrombosis Center, Az Ospedaliera Careggi, University of Florence, Italy.

出版信息

Thromb Haemost. 2001 Sep;86(3):772-6.

PMID:11583306

Abstract

Few and contrasting data are available on the prevalence of hemostatic risk factors in patients with central retinal vein occlusion (CRVO). Aim of this study was to investigate the metabolic and inherited risk factors for venous thrombosis in 100 CRVO patients (age: 59 yrs; range 18-77) and in 100 controls (age: 56 yrs; range 18-84). In patients homocysteine (Hcy) levels were significantly higher than in controls and were affected by the C677T methylenetetrahydrofolate reductase (MTHFR) polymorphism (p < 0.001). The prevalences of activated protein C resistance (APCR), factor V Leiden positivity, elevated PAI-1 and Lp(a) levels were significantly higher in patients with respect to controls. At multivariate analysis, only hyperhomocysteinemia (OR 11, 95% CI 3.6-36.2; p < 0.0001) and elevated PAI-1 levels (OR 8.9, 95% CI 3.5-41.3; p < 0.01), in addition to hypertension (OR 40.5, 95% CI 8.6-188.8; p < 0.00001) and hypercholesterolemia (OR 3.1, 95% CI 1.6-20.5; p < 0.05), were independent risk factors for CRVO. These data demonstrate a potential role of hemostatic risk factors in the pathophysiology of CRVO.

摘要

关于视网膜中央静脉阻塞（CRVO）患者止血危险因素的患病率，现有数据较少且相互矛盾。本研究的目的是调查100例CRVO患者（年龄：59岁；范围18 - 77岁）和100例对照者（年龄：56岁；范围18 - 84岁）中静脉血栓形成的代谢和遗传危险因素。患者的同型半胱氨酸（Hcy）水平显著高于对照组，且受C677T亚甲基四氢叶酸还原酶（MTHFR）基因多态性影响（p < 0.001）。与对照组相比，患者中活化蛋白C抵抗（APCR）、因子V莱顿阳性、PAI - 1和Lp(a)水平升高的患病率显著更高。多因素分析显示，除高血压（OR 40.5，95% CI 8.6 - 188.8；p < 0.00001）和高胆固醇血症（OR 3.1，95% CI 1.6 - 20.5；p < 0.05）外，只有高同型半胱氨酸血症（OR 11，95% CI 3.6 - 36.2；p < 0.0001）和升高的PAI - 1水平（OR 8.9，95% CI 3.5 - 41.3；p < 0.01）是CRVO的独立危险因素。这些数据表明止血危险因素在CRVO的病理生理学中具有潜在作用。