凝血酶原20210A与口服避孕药作为脑静脉血栓形成的危险因素

Prothrombin 20210A and oral contraceptive use as risk factors for cerebral venous thrombosis.

作者信息

Gadelha Telma, André Charles, Jucá Andreza A V, Nucci Márcio

机构信息

Hematology, Department of Internal Medicine, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, RJ 21941-590, Brazil.

出版信息

Cerebrovasc Dis. 2005;19(1):49-52. doi: 10.1159/000081911. Epub 2004 Nov 3.

DOI:10.1159/000081911

PMID:15528884

Abstract

BACKGROUND

This study investigates the association between cerebral vein thrombosis (CVT) and the mutations FV 1691A (factor V Leiden), PT 20210A and MTHFR 677TT and acquired factors including oral contraceptive (OC) use.

METHODS

26 patients (21 females) and 217 healthy controls (134 females) were studied. Multiple regression analysis was performed.

RESULTS

The frequency of the three mutations in cases and controls were: PT 20210A, 23 versus 1%, odds ratio (OR) 21.40 (95% CI 4.29-118.75), p < 0.001; FV 1691A, 8 versus 1%, OR 5.94 (95% CI 0.66-46.9); MTHFR 677TT, 4 versus 7%, OR 0.54 (95% CI 0.03-4.08). OC use was more frequent in female patients over 14 years old than in controls (84 vs. 40%, OR 8.15, 95% CI 2.09-37.13, p < 0.001). The model that best explained the thrombotic risk included PT 20210A and OC use.

CONCLUSIONS

PT 20210A and OC use are the main thrombophilic risk factors predisposing to CVT and should be routinely investigated in patients with this disease.

摘要

背景

本研究调查脑静脉血栓形成（CVT）与FV 1691A（因子V莱顿）、PT 20210A和MTHFR 677TT突变以及包括使用口服避孕药（OC）在内的获得性因素之间的关联。

方法

对26例患者（21例女性）和217名健康对照者（134例女性）进行研究。进行多元回归分析。

结果

病例组和对照组中三种突变的发生率分别为：PT 20210A，23例对1例，比值比（OR）21.40（95%可信区间4.29 - 118.75），p < 0.001；FV 1691A，8例对1例，OR 5.94（95%可信区间0.66 - 46.9）；MTHFR 677TT，4例对7例，OR 0.54（95%可信区间0.03 - 4.08）。14岁以上女性患者使用OC的频率高于对照组（84%对40%，OR 8.15，95%可信区间2.09 - 37.13，p < 0.001）。最能解释血栓形成风险的模型包括PT 20210A和使用OC。