Kyrle Paul A, Hron Gregor, Eichinger Sabine, Wagner Oswald
Department of Medicine I, Medical University of Vienna, Vienna, Austria.
Thromb Haemost. 2007 Jun;97(6):880-3.
The clinical relevance of high P-selectin levels in venous thrombosis is unknown. We prospectively followed 544 patients with first unprovoked venous thromboembolism (VTE) after cessation of anticoagulation and evaluated P-selectin as a risk factor of recurrent VTE. VTE recurred in 63 (12%) patients. Patients with recurrence had significantly higher P-selectin levels than those without (45.8 mg/dl +/- 16.4 vs. 40.1 mg/dl +/- 13.3; p = 0.006). After four years, the probability of recurrence was 20.6% (95% confidence interval [CI] 12.6-28.5) among patients with P-selectin values above the 75(th) percentile of the patient population and was 10.8% (95% CI 7.2-14.3) among patients with lower values (p = 0.046). Compared to patients with low P-selectin, adjusted risk of recurrence was 1.7-fold (95% CI 1.0-2.9, p = 0.045) increased among patients with P-selectin levels exceeding the 75(th) percentile. We conclude that high circulating P-selectin is a risk factor of recurrent VTE.
高P选择素水平在静脉血栓形成中的临床相关性尚不清楚。我们对544例首次发生不明原因静脉血栓栓塞（VTE）且抗凝治疗停止后的患者进行了前瞻性随访，并将P选择素作为复发性VTE的危险因素进行评估。63例（12%）患者出现VTE复发。复发患者的P选择素水平显著高于未复发患者（45.8mg/dl±16.4 vs. 40.1mg/dl±13.3；p = 0.006）。四年后，P选择素值高于患者群体第75百分位数的患者复发概率为20.6%（95%置信区间[CI] 12.6 - 28.5），而值较低的患者复发概率为10.8%（95%CI 7.2 - 14.3）（p = 0.046）。与低P选择素患者相比，P选择素水平超过第75百分位数的患者复发调整风险增加1.7倍（95%CI 1.0 - 2.9，p = 0.045）。我们得出结论，循环中高P选择素是复发性VTE的危险因素。
