Lippi Giuseppe, Franchini Massimo, Targher Giovanni, Montagnana Martina, Salvagno Gian Luca, Guidi Gian Cesare, Favaloro Emmanuel J
Sezione di Chimica Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Ospedale Policlinico GB Rossi, Piazzale Scuro, Verona, Italy.
J Thromb Thrombolysis. 2009 Oct;28(3):362-5. doi: 10.1007/s11239-008-0269-z. Epub 2008 Sep 12.
Although clinical evidence supports a plausible association between thyroid disorders and venous thrombosis, reliable evidence is so far lacking on the potential biological mechanisms and neither temporary nor permanent thromboembolic risk factors were constantly identified. We performed a 2-years retrospective analysis to retrieve combined results of activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen, and thyroid stimulating hormone (TSH), performed on outpatients over 15 years of age and referred by general practitioners for routine blood testing. Cumulative results were retrieved for 1,329 such outpatients. Patients with hyperthyroidism had shortened APTT (28.4 vs. 29.4 s; P = 0.043) and higher fibrinogen (4.1 vs. 3.8 g/l; P = 0.028) values when compared with euthyroid patients, whereas no significant differences were observed between euthyroid patients and those with hypothyroidism. Hyperthyroid patients had also an increased prevalence of shortened APTTs (<25.5 s) and higher values of fibrinogen (>4.0 g/l) than those with normal thyroid function. This study confirms that hyperthyroidism might be associated with hypercoagulability due to shortened APTT and increased fibrinogen values. Should these findings be confirmed, consideration should be given to prevent thrombotic complications in patients with hyperthyroidism.
尽管临床证据支持甲状腺疾病与静脉血栓形成之间存在合理关联,但目前仍缺乏关于潜在生物学机制的可靠证据,而且无论是暂时的还是永久的血栓栓塞风险因素都尚未得到持续确认。我们进行了一项为期两年的回顾性分析,以获取活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原和促甲状腺激素(TSH)的综合结果,这些结果来自15岁以上的门诊患者,由全科医生转诊进行常规血液检测。共获取了1329名此类门诊患者的累积结果。与甲状腺功能正常的患者相比,甲状腺功能亢进患者的APTT缩短(28.4秒对29.4秒;P = 0.043),纤维蛋白原水平更高(4.1克/升对3.8克/升;P = 0.028),而甲状腺功能正常的患者与甲状腺功能减退患者之间未观察到显著差异。甲状腺功能亢进患者中APTT缩短(<25.5秒)和纤维蛋白原水平升高(>4.0克/升)的患病率也高于甲状腺功能正常的患者。本研究证实,甲状腺功能亢进可能与由于APTT缩短和纤维蛋白原水平升高导致的高凝状态有关。如果这些发现得到证实,应考虑预防甲状腺功能亢进患者的血栓形成并发症。