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年轻急性心肌梗死患者的血栓形成倾向

Thrombophilia in young patients with acute myocardial infarction.

作者信息

Celik Murat, Altintas Abdullah, Celik Yusuf, Karabulut Aziz, Ayyildiz Orhan

机构信息

Internal Medicine, Clinical of Internal Diseases, Nusaybin State Hospital, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.

出版信息

Saudi Med J. 2008 Jan;29(1):48-54.

PMID:18176672
Abstract

OBJECTIVE

To investigate the association of thrombophilia and coronary artery disease (CAD) in patients with myocardial infarction (MI).

METHODS

Under the age of 45 years, 129 patients with MI and 107 control subjects were included into the study. Traditional risk factors of CAD and protein C, S, antithrombin III deficiencies, factor V Leiden (FV Leiden), prothrombin G20210A and methylenetetrahydrofolate reductase (MTHFR) C677T mutations were investigated.

RESULTS

There were statistically significant differences in terms of obesity, smoking, triglyceride, total cholesterol, high-density lipoprotein, high-density lipoprotein, and very-low-density lipoprotein cholesterol, family history, hypertension, diabetes, and left ventricular hypertrophy between patients and controls. None of the patients and controls had protein C, protein S, and antithrombin III deficiencies. Ten patients (7.8%) and 4 controls (3.7%) had heterozygote FV Leiden mutation. Homozygous prothrombine G20210A gene mutation was detected in one patient (1.1%). Homozygous MTHFR C677T mutation was observed in 7.8% (patients) and in 6.5% (controls). Heterozygous MTHFR C677T mutation was detected 36.4% in patients and 31.7% in controls. The difference was not statistically significant in terms of carriage of thrombophilic mutations.

CONCLUSION

We found that traditional risk factors increased the risk of CAD. Prothrombin G20210A, FV Leiden and MTHFR C677T mutations, protein C, S and AT-III deficiencies did not increase the risk of CAD in our young population.

摘要

目的

研究心肌梗死(MI)患者中血栓形成倾向与冠状动脉疾病(CAD)的关联。

方法

纳入年龄在45岁以下的129例MI患者和107例对照者。研究CAD的传统危险因素以及蛋白C、S、抗凝血酶III缺乏症、因子V莱顿(FV莱顿)、凝血酶原G20210A和亚甲基四氢叶酸还原酶(MTHFR)C677T突变。

结果

患者与对照者在肥胖、吸烟、甘油三酯、总胆固醇、高密度脂蛋白、高密度脂蛋白和极低密度脂蛋白胆固醇、家族史、高血压、糖尿病和左心室肥厚方面存在统计学显著差异。患者和对照者均无蛋白C、蛋白S和抗凝血酶III缺乏症。10例患者(7.8%)和4例对照者(3.7%)有杂合子FV莱顿突变。在1例患者(1.1%)中检测到纯合子凝血酶原G20210A基因突变。7.8%的患者(对照者为6.5%)观察到纯合子MTHFR C677T突变。患者中杂合子MTHFR C677T突变检出率为36.4%,对照者为31.7%。血栓形成倾向突变的携带情况差异无统计学意义。

结论

我们发现传统危险因素会增加CAD风险。在我们的年轻人群中,凝血酶原G20210A、FV莱顿和MTHFR C677T突变以及蛋白C、S和AT-III缺乏症并未增加CAD风险。

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