Khor Bernard, Van Cott Elizabeth M
Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Jackson 235, 55 Fruit Street, Boston, MA 02114, USA.
Clin Lab Med. 2009 Jun;29(2):339-66. doi: 10.1016/j.cll.2009.03.002.
This discussion considers several important hypercoagulable states that predispose patients to venous, and in some instances, arterial thrombosis, focusing on activated protein C resistance/factor V Leiden, prothrombin G20210A, deficiencies of protein C, protein S or antithrombin, and antiphospholipid antibodies. The discussion includes the incidence of each hypercoagulable condition, the magnitude of the thrombotic risk it poses and synergistic interactions among the various hypercoagulable conditions. Salient advances in understanding the molecular pathogenesis of each condition are presented and discussed in the context of the interpretation and clinical utility of current laboratory testing and identifying potential targets of future testing. Finally, recommendations for laboratory testing are summarized.
本讨论考虑了几种重要的易栓状态,这些状态使患者易发生静脉血栓,在某些情况下还易发生动脉血栓,重点关注活化蛋白C抵抗/因子V莱顿突变、凝血酶原G20210A、蛋白C、蛋白S或抗凝血酶缺乏以及抗磷脂抗体。讨论内容包括每种易栓状态的发生率、其带来的血栓形成风险程度以及各种易栓状态之间的协同相互作用。在当前实验室检测的解释和临床应用以及确定未来检测潜在靶点的背景下,介绍并讨论了对每种状态分子发病机制理解的显著进展。最后,总结了实验室检测的建议。