Austin Harland, Key Nigel S, Benson Jane M, Lally Cathy, Dowling Nicole F, Whitsett Carolyn, Hooper W Craig
Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Blood. 2007 Aug 1;110(3):908-12. doi: 10.1182/blood-2006-11-057604. Epub 2007 Apr 4.
People with sickle cell disease have a chronically activated coagulation system and display hemostatic perturbations, but it is unknown whether they experience an increased risk of venous thromboembolism. We conducted a case-control study of venous thromboembolism that included 515 hospitalized black patients and 555 black controls obtained from medical clinics. All subjects were assayed for hemoglobin S and hemoglobin C genotypes. The prevalence of the S allele was 0.070 and 0.032 for case patients and controls, respectively (P < .001). The odds that a patient had sickle cell trait were approximately twice that of a control, indicating that the risk of venous thromboembolism is increased approximately 2-fold among blacks with sickle cell trait compared with those with the wild-type genotype (odds ratio = 1.8 with 95% confidence interval, 1.2-2.9). The odds ratio for pulmonary embolism and sickle cell trait was higher, 3.9 (2.2-6.9). The prevalence of sickle cell disease was also increased among case patients compared with controls. We conclude that sickle cell trait is a risk factor for venous thromboembolism and that the proportion of venous thromboembolism among blacks attributable to the mutation is approximately 7%.
镰状细胞病患者的凝血系统长期处于激活状态，并表现出止血功能紊乱，但他们是否面临静脉血栓栓塞风险增加尚不清楚。我们开展了一项静脉血栓栓塞病例对照研究，纳入了515名住院黑人患者以及从医疗诊所选取的555名黑人对照。对所有受试者进行了血红蛋白S和血红蛋白C基因型检测。病例组患者和对照组中S等位基因的患病率分别为0.070和0.032（P <.001）。患者携带镰状细胞性状的几率约为对照组的两倍，这表明与野生型基因型者相比，携带镰状细胞性状的黑人发生静脉血栓栓塞的风险增加了约2倍（比值比 = 1.8，95%置信区间为1.2 - 2.9）。肺栓塞与镰状细胞性状的比值比更高，为3.9（2.2 - 6.9）。与对照组相比，病例组患者中镰状细胞病的患病率也有所增加。我们得出结论，镰状细胞性状是静脉血栓栓塞的一个危险因素，且黑人中因该突变导致的静脉血栓栓塞比例约为7%。
