Poul H
Oddĕlení hematologie a transfuziologie Nemocnice Pelhrimov.
Vnitr Lek. 2006 Mar;52 Suppl 1:17-25.
Thrombophilic conditions are congenital or acquired hemostatic disorders pathophysiologically or statistically associated with higher risk of thrombosis. Their most important clinical manifestation is venous thromboembolism. In more than 50% of persons with non-induced thrombosis, some of the known thrombophilias can be found. Persons with congenital thrombophilias have, contrary to those without any thrombophilias, most of all an increased risk of an initial thromboembolic event while the impact of congenital thrombophilic conditions on their recurrence is not so clear. In patients with idiopathic thrombosis is the risk of recurrence 7-10% a year even at the absence of known thrombophilias. The risk of a recurrent event is influenced by a set of other factors (prevailing or undetected trigger factor, proximal thrombosis and pulmonary embolism, incomplete rechanneling of a thrombotic vein, presence of some thrombophilias, high level of D-dimers after discontinuation of the anticoagulant treatment). Their identification and consequent monitoring are decisive in the choice of an optimum treatment and the duration of their administration in secondary prevention of venous thromboembolism. In the primary venous thrombosis prevention, the knowledge of general trigger factors and the individual risk characteristics of the given patient is important, which means also timely detection of thrombophilic conditions in patients who profit from it, i.e. if they display at least medium probability of detection. A universal long-term prophylaxis in so far asymptomatic carriers of congenital thrombophilias is not indicated with regard to potential complications of anticoagulant treatment. Women with thrombophilic disorders are under an increased risk of a thromboembolic event when using hormonal contraceptives and during pregnancy. There is also a higher incidence of pregnancy complications connected with disorders in blood circulation of placental vascular tree.
易栓症是先天性或后天获得性止血障碍，在病理生理学或统计学上与血栓形成风险较高相关。其最重要的临床表现是静脉血栓栓塞。在超过50%的非诱发性血栓形成患者中，可发现一些已知的易栓症。与无任何易栓症的人相比，先天性易栓症患者首先发生初始血栓栓塞事件的风险增加，而先天性易栓症对其复发的影响尚不清楚。在特发性血栓形成患者中，即使不存在已知的易栓症，每年复发的风险也为7-10%。复发性事件的风险受一系列其他因素影响（主要或未检测到的触发因素、近端血栓形成和肺栓塞、血栓形成静脉的再通不完全、某些易栓症的存在、抗凝治疗停止后D-二聚体水平升高）。对这些因素的识别及随后的监测对于选择最佳治疗方法以及在静脉血栓栓塞二级预防中确定治疗持续时间起着决定性作用。在原发性静脉血栓形成预防中，了解一般触发因素和特定患者的个体风险特征很重要，这也意味着要及时检测出能从中受益的患者的易栓症，即如果他们至少显示出中等检测概率。鉴于抗凝治疗的潜在并发症，不建议对先天性易栓症的无症状携带者进行普遍的长期预防。患有易栓症的女性在使用激素避孕药期间及怀孕期间发生血栓栓塞事件的风险增加。与胎盘血管树血液循环紊乱相关的妊娠并发症发生率也较高。
