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[因子V莱顿突变与心肌梗死:1例病例及文献复习与荟萃分析]

[Factor V Leiden and myocardial infarction: a case, review of the literature with a meta-analysis].

作者信息

Doix S, Mahrousseh M, Jolak M, Laurent Y, Lorenzini J L, Binquet C, Zeller M, Cottin Y, Wolf J E

机构信息

Unité de soins intensifs cardiologie, hôpital R.-Morlevat, 21140 Semur-en-Auxois, France.

出版信息

Ann Cardiol Angeiol (Paris). 2003 Jun;52(3):143-9. doi: 10.1016/s0003-3928(02)00192-0.

Abstract

Mutation in blood coagulation factor V Leiden is the most frequently genetic polymorphism implied in venous thrombosis. A 57 year old man was hospitalised for acute myocardial infarction (MI). An emergency coronary angiography was performed, and no significant stenosis was observed. The haematologic check-up showed an heterozygous Leiden mutation of factor V. We report all publications about the relation between factor V Leiden and coronary thrombosis, and we performed a meta-analysis. We analysed the relation in general population and in subgroups, such as, younger and older, and patient with or without coronary stenosis. In global population, the meta-analysis did not found significant association between Factor V Leiden and myocardial infarction (OR = 1.25; IC = 0.97-1.58). In contrast, in patients less than < 55 years old after MI, Factor V Leiden prevalence was significantly higher than in control group (OR = 1.48; IC = 1.05-2.08). In addition, after MI without significant coronary stenosis Factor V Leiden prevalence was significantly higher than in normal patients (OR = 2.84; IC = 1.46-5.51). After MI, in patients without significant coronary stenosis, Factor V Leiden prevalence was significantly higher than in patients with significant coronary stenosis (OR = 3.26; IC = 1.67-6.36). Our study suggests that Factor V Leiden could be search after MI in young subjects and/or without significant stenosis.

摘要

凝血因子V莱顿突变是静脉血栓形成中最常见的基因多态性。一名57岁男性因急性心肌梗死(MI)住院。进行了急诊冠状动脉造影,未观察到明显狭窄。血液学检查显示因子V的杂合性莱顿突变。我们报告了所有关于因子V莱顿与冠状动脉血栓形成关系的出版物,并进行了荟萃分析。我们分析了一般人群以及亚组中的关系,例如年轻和老年人群,以及有或无冠状动脉狭窄的患者。在总体人群中,荟萃分析未发现因子V莱顿与心肌梗死之间存在显著关联(OR = 1.25;IC = 0.97 - 1.58)。相比之下,在MI后年龄小于55岁的患者中,因子V莱顿的患病率显著高于对照组(OR = 1.48;IC = 1.05 - 2.08)。此外,在无明显冠状动脉狭窄的MI后患者中,因子V莱顿的患病率显著高于正常患者(OR = 2.84;IC = 1.46 - 5.51)。在MI后,无明显冠状动脉狭窄的患者中因子V莱顿的患病率显著高于有明显冠状动脉狭窄的患者(OR = 3.26;IC = 1.67 - 6.36)。我们的研究表明,在年轻受试者和/或无明显狭窄的MI后患者中可能需要筛查因子V莱顿。

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