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V617F Jak2突变与原发性血小板增多症或原发性骨髓纤维化患者血栓形成风险的关联:一项系统评价

Association of V617F Jak2 mutation with the risk of thrombosis among patients with essential thrombocythaemia or idiopathic myelofibrosis: a systematic review.

作者信息

Lussana Federico, Caberlon Sabrina, Pagani Chiara, Kamphuisen Pieter W, Büller Harry R, Cattaneo Marco

机构信息

Divisione di Medicina Generale III, Azienda Ospedaliera San Paolo Dipartimento di Medicina, Chirurgia e Odontoiatria, Università di Milano, Via A. di Rudinì 8, Milan, Italy.

出版信息

Thromb Res. 2009 Sep;124(4):409-17. doi: 10.1016/j.thromres.2009.02.004. Epub 2009 Mar 18.

Abstract

INTRODUCTION

Many studies evaluated the association of V617F Jak-2 with the risk of thrombosis in patients with essential thrombocythaemia, but the results of these studies were inconsistent. Few studies evaluated the association of V617F Jak-2 mutation with the risk of thrombosis in patients with idiopathic myelofibrosis. Therefore, we performed a systematic review of the studies that assessed the risk of thrombosis associated with V617F Jak-2 in patients with ET or IM.

MATERIALS AND METHODS

We searched MEDLINE and EMBASE databases and reference lists of retrieved articles. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated for each trial and pooled.

RESULTS

We included 21 studies involving patients with essential thrombocythaemia and 6 studies patients with idiopathic myelofibrosis. In essential thrombocythaemia patients, V617F Jak-2 was associated with a significant increased risk of thrombosis (OR 1.92, 95% CI 1.45-2.53), both of venous (OR 2.49, 95% CI 1.71-3.61) and arterial (OR 1.77, 95% CI 1.29-2.43) vessels. In idiopathic myelofibrosis patients, the risk of thrombosis associated with V617F Jak-2 tended to be increased (OR 1.76, 95% CI 0.91-3.41).

CONCLUSIONS

Our systematic review suggests that V617F Jak-2 increases the risk of thrombosis in essential thrombocythaemia patients by about two fold while its role in idiopathic myelofibrosis patients is uncertain.

摘要

引言

许多研究评估了V617F Jak-2与原发性血小板增多症患者血栓形成风险之间的关联,但这些研究结果并不一致。很少有研究评估V617F Jak-2突变与原发性骨髓纤维化患者血栓形成风险之间的关联。因此,我们对评估原发性血小板增多症(ET)或原发性骨髓纤维化(IM)患者中与V617F Jak-2相关的血栓形成风险的研究进行了系统评价。

材料与方法

我们检索了MEDLINE和EMBASE数据库以及检索文章的参考文献列表。计算每个试验的比值比(OR)和95%置信区间(CI)并进行汇总。

结果

我们纳入了21项涉及原发性血小板增多症患者的研究和6项涉及原发性骨髓纤维化患者的研究。在原发性血小板增多症患者中,V617F Jak-2与静脉(OR 2.49,95%CI 1.71-3.61)和动脉(OR 1.77,95%CI 1.29-2.43)血管血栓形成风险显著增加相关。在原发性骨髓纤维化患者中,与V617F Jak-2相关的血栓形成风险有增加趋势(OR 1.76,95%CI 0.91-3.41)。

结论

我们的系统评价表明,V617F Jak-2使原发性血小板增多症患者的血栓形成风险增加约两倍,而其在原发性骨髓纤维化患者中的作用尚不确定。

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