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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.

DOI:10.1016/s0003-3928(02)00192-0
PMID:12938565
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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1
[Factor V Leiden and myocardial infarction: a case, review of the literature with a meta-analysis].[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]
Ann Cardiol Angeiol (Paris). 2003 Jun;52(3):143-9. doi: 10.1016/s0003-3928(02)00192-0.
2
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Potential thrombophilic mutations/polymorphisms in patients with no flow-limiting stenosis after myocardial infarction.心肌梗死后无血流限制性狭窄患者潜在的血栓形成倾向突变/多态性
Am Heart J. 2003 Jan;145(1):118-24. doi: 10.1067/mhj.2003.29.
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[Effects of factor V Leiden mutations on prognosis in patients with acute myocardial infarction].[凝血因子V莱顿突变对急性心肌梗死患者预后的影响]
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Prevalence of factor V Leiden and prothrombin variant G20210A in patients age <50 years with no significant stenoses at angiography three to four weeks after myocardial infarction.心肌梗死后三至四周行血管造影无明显狭窄的50岁以下患者中因子V莱顿突变和凝血酶原变异体G20210A的患病率。
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Prevalence of resistance against activated protein C resulting from factor V Leiden is significantly increased in myocardial infarction: investigation of 507 patients with myocardial infarction.心肌梗死患者中,因因子V莱顿突变导致的对活化蛋白C抵抗的患病率显著增加:对507例心肌梗死患者的调查。
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Interaction of coagulation defects and cardiovascular risk factors: increased risk of myocardial infarction associated with factor V Leiden or prothrombin 20210A.凝血缺陷与心血管危险因素的相互作用:与因子V莱顿突变或凝血酶原20210A相关的心肌梗死风险增加。
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Factor V R506Q mutation-Leiden: an independent risk factor for venous thrombosis but not coronary artery disease.凝血因子V R506Q突变-莱顿:静脉血栓形成的独立危险因素,但非冠状动脉疾病的独立危险因素。
J Thromb Thrombolysis. 2001 Apr;11(2):111-6. doi: 10.1023/a:1011268531377.

引用本文的文献

1
Multiple simultaneous venous and arterial thromboses in a patient with factor V Leiden disorder: Detection by multislice computed tomography.一名患有因子V莱顿突变症的患者同时出现多处静脉和动脉血栓形成:通过多层计算机断层扫描检测。
Interv Med Appl Sci. 2015 Mar;7(1):38-41. doi: 10.1556/IMAS.6.2014.006. Epub 2015 Mar 20.
2
Life-threatening aortic thrombosis in a trauma patient homozygous for factor V Leiden mutation: Case report.创伤患者因子 V 莱顿突变纯合子致危及生命的主动脉血栓形成:病例报告。
Thromb J. 2011 May 9;9:8. doi: 10.1186/1477-9560-9-8.