Martinelli Ida
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Maggiore Hospital, University of Milan, Italy.
Pathophysiol Haemost Thromb. 2002 Sep-Dec;32(5-6):343-5. doi: 10.1159/000073595.
Venous thromboembolism (VTE) results from multiple interactions between inherited and environmental risk factors. The lower limbs are the most common site of VTE, but more rarely other venous sites can be involved. The role of risk factors for VTE can be different in the various thrombotic manifestations, and there are specific risk factors for specific sites. Coagulation abnormalities causing inherited thrombophilia are frequently found in patients with cerebral vein thrombosis, but are more rare in those with "isolated" pulmonary embolism, upper limb or retinal vein thrombosis. Transient situations, such as surgery, trauma, prolonged immobilization, the use of oral contraceptives or hormone replacement therapy, and pregnancy or puerperium, are often recognized in patients with lower limb deep vein thrombosis, "isolated" pulmonary embolism, abdominal and cerebral vein thrombosis, but not in patients with upper limb deep vein thrombosis. Major risk factors for deep vein thrombosis of the upper limbs are strong efforts with the arms, whereas for abdominal vein thrombosis are myeloproliferative disorders and liver cirrhosis. In conclusion, there is increasing evidence that inherited and environmental risk factors may interact differently in determining VTE in different sites.
静脉血栓栓塞症（VTE）是由遗传和环境风险因素之间的多种相互作用引起的。下肢是VTE最常见的部位，但其他静脉部位受累的情况较少见。VTE风险因素在不同的血栓形成表现中作用可能不同，且特定部位有特定的风险因素。导致遗传性易栓症的凝血异常在脑静脉血栓形成患者中经常发现，但在“孤立性”肺栓塞、上肢或视网膜静脉血栓形成患者中则较为罕见。诸如手术、创伤、长期制动、使用口服避孕药或激素替代疗法以及妊娠或产褥期等短暂情况，在下肢深静脉血栓形成、“孤立性”肺栓塞、腹部和脑静脉血栓形成患者中经常被发现，但在上肢深静脉血栓形成患者中则不然。上肢深静脉血栓形成的主要风险因素是手臂用力过度，而腹部静脉血栓形成的风险因素是骨髓增殖性疾病和肝硬化。总之，越来越多的证据表明，遗传和环境风险因素在不同部位VTE的发生中可能有不同的相互作用方式。
