Oger Emmanuel, Mottier Dominique
Université de Bretagne occidentale, GETBO EA-3878, hôpital de la Cavale-Blanche, 29609 Brest.
Rev Prat. 2007 Apr 15;57(7):711-3, 716, 719-20.
Venous thromboembolism is predominantly a disease of older age. The average annual incidence rate of venous thromboembolism among Caucasians is 1 per 1,000 person-years. Common independent VTE risk factors include hospitalization, active cancer, neurological disease with extremity paresis and, among women, oral contraceptives, pregnancy and the puerperium, and hormone therapy. Inherited reductions in plasma natural anticoagulants (antithrombin, protein C, or protein S) have long been recognized as uncommon but potent risk factors for venous thromboembolism. Activated protein C resistance (factor V Leiden), G20210 variant in the prothrombin gene have been recently added to the list of inherited disorders predisposing to thrombosis. Those latter frequent inherited factors interact with environmental risk factors such as oral contraceptives, pregnancy, hormone therapy.
静脉血栓栓塞主要是一种老年疾病。白种人中静脉血栓栓塞的年平均发病率为每1000人年1例。常见的独立静脉血栓栓塞风险因素包括住院、活动性癌症、伴有肢体麻痹的神经疾病,以及在女性中,口服避孕药、妊娠和产褥期、激素治疗。长期以来,血浆天然抗凝剂(抗凝血酶、蛋白C或蛋白S)的遗传性降低一直被认为是静脉血栓栓塞的罕见但强效的风险因素。活化蛋白C抵抗(因子V莱顿)、凝血酶原基因中的G20210变体最近被列入易患血栓形成的遗传性疾病名单。那些常见的遗传因素与环境风险因素相互作用,如口服避孕药、妊娠、激素治疗。