Ruiz-Argüelles Guillermo J, González-Carrillo Martha L, Estrada-Gómez Roberto, Valdés-Tapia Patricia, Parra-Ortega Israel, Porras-Juárez Angélica
Centro de Hematología y Medicina Intema de Puebla, Puebla, México.
Gac Med Mex. 2007 Jul-Aug;143(4):317-22.
Over a 70-month period, 100 consecutive Mexican mestizo individuals with a clinical marker associated with a primary hypercoagulable state were studied.
We prospectively assessed: the sticky platelet syndrome (SPS), the activated protein C resistance (aPCR) phenotype, coagulation protein C activity and antigen, coagulation protein S, antithrombin III, plasminogen, IgG and IgM isotypes of antiphospholipid antibodies, homocysteine levels, the factor V gene Leiden, Cambridge, Hong Kong, and Liverpool mutations, the 677 C-->T mutation in the 5,10-methylenetetrahydrofolatereductase (MTHFR), and the G20210A polymorphism in the 3'-untranslated region of the prothrombin gene.
Of the 100 consecutive patients prospectively accrued in the study, only 29% were males. In only 6 individuals could we not record any abnormality, whereas in most individuals (81%), two to five co-existing abnormalities were identified. In a multivariate analysis of the association of all these assesments, the only significant association was found between the factor V Leiden mutation and the aPCR phenotype (r = .495; p < 0.001).
These results confirm previous observations on thrombophilia in Mexico underlining that it is a multifactorial disease. They also suggest that the abnormalities detected are not associated to each other.
在70个月的时间里,对100名连续的患有与原发性高凝状态相关临床标志物的墨西哥混血个体进行了研究。
我们前瞻性地评估了:粘性血小板综合征(SPS)、活化蛋白C抵抗(aPCR)表型、凝血蛋白C活性和抗原、凝血蛋白S、抗凝血酶III、纤溶酶原、抗磷脂抗体的IgG和IgM同种型、同型半胱氨酸水平、因子V基因Leiden突变、剑桥、香港和利物浦突变、5,10-亚甲基四氢叶酸还原酶(MTHFR)中的677 C→T突变以及凝血酶原基因3'-非翻译区的G20210A多态性。
在该研究中前瞻性纳入的100名连续患者中,只有29%为男性。只有6名个体我们未记录到任何异常,而在大多数个体(81%)中,发现了两到五种并存的异常。在对所有这些评估的关联进行多变量分析时,仅在因子V Leiden突变与aPCR表型之间发现了显著关联(r = 0.495;p < 0.001)。
这些结果证实了之前关于墨西哥血栓形成倾向的观察结果,强调这是一种多因素疾病。它们还表明检测到的异常彼此之间没有关联。