Milio Glauco, Siragusa Sergio, Minà Chiara, Amato Corrado, Corrado Egle, Grimaudo Stefania, Novo Salvatore
University of Palermo - Department of Internal Medicine, Cardiovascular and Nephrourological Diseases, Italy.
Thromb Res. 2008;123(2):194-9. doi: 10.1016/j.thromres.2008.01.013. Epub 2008 Apr 2.
Superficial venous thrombosis (SVT) has been considered for a long time a limited clinical condition with a low importance, but this approach has changed in recent years, when several studies demonstrated spreading to deep veins occurring from 7.3 to 44%, with high prevalence of pulmonary embolism.
To evaluate the prevalence of genetic risk factors for VTE in patients suffering from SVT on both normal and varicose vein, and to understand their role on spreading to deep veins, we studied 107 patients with SVT, without other risk factors. Ultrasound examination was performed, and the presence of FV Leiden, Prothrombin G20210A mutation, and MTHFR C677T mutation was researched.
In the patients where SVT occurred in normal veins, the presence of FV Leiden was 26.3% of the non-spreading and 60% of the spreading to deep veins SVT; Prothrombin mutation was found in 7.9% of the former case and in 20% of the latter; MTHFR C677T mutation was found respectively in 23.7% and 40%. In the patients with SVT on varicose veins, the presence of these factors was less evident (6.7%, 4.4% and 6.7% respectively), but their prevalence was considerably higher (35.7%, 7.4% and 21.4% respectively) in SVT spreading to deep veins than in non-spreading.
Our data demonstrate the high prevalence of these mutations, especially FV Leiden and associations, in patients with SVT on normal veins and their role in the progression to deep vein system.
长期以来,浅静脉血栓形成(SVT)一直被认为是一种临床意义有限、重要性较低的疾病,但近年来这种观点有所改变,多项研究表明其蔓延至深静脉的发生率为7.3%至44%,肺栓塞的患病率较高。
为评估正常静脉和曲张静脉中患SVT患者发生静脉血栓栓塞(VTE)的遗传危险因素患病率,并了解这些因素在蔓延至深静脉过程中的作用,我们研究了107例无其他危险因素的SVT患者。进行了超声检查,并检测了凝血因子V莱顿(FV Leiden)、凝血酶原G20210A突变和亚甲基四氢叶酸还原酶(MTHFR)C677T突变的存在情况。
在正常静脉发生SVT的患者中,FV Leiden在未蔓延至深静脉的病例中占26.3%,在蔓延至深静脉的SVT病例中占60%;凝血酶原突变在前一种情况中占7.9%,在后一种情况中占20%;MTHFR C677T突变分别占23.7%和40%。在曲张静脉发生SVT的患者中,这些因素的存在不太明显(分别为6.7%、4.4%和6.7%),但在蔓延至深静脉的SVT中,其患病率比未蔓延的情况高得多(分别为35.7%、7.4%和21.4%)。
我们的数据表明,这些突变,尤其是FV Leiden及其相关性,在正常静脉患SVT的患者中患病率较高,且在进展至深静脉系统过程中发挥作用。