Chotanaphuti Thanainit, Heebthamai Danai, Chuwong Montri, Kanchanaroek Kris
Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
J Med Assoc Thai. 2009 Dec;92 Suppl 6:S141-6.
Thrombophilia is the propensity to develop thrombosis (blood clots) within the vein or artery due to an abnormality in the system of coagulation. It is one of the pathophysiological causes of osteonecrosis of femoral head (ONFH). Previous studies showed that the prevalence of thrombophilia was 1-15% in normal population. There are two types of osteonecrosis of the femoral head, primary osteonecrosis (idiopathic osteonecrosis) and secondary osteonecrosis from other known conditions. There is no previous report of the prevalence of thrombophilia in idiopathic osteonecrosis of the femoral head in Thailand.
To study the prevalence of thrombophilia in Thai patients with idiopathic osteonecrosis of the femoral head.
Fifty-five patients with osteonecrosis of femoral head were enrolled in this study. Forty patients had idiopathic osteonecrosis and 15 patients had secondary osteonecrosis. The blood examination of Factor V Leiden mutant, Factor VIII, Protein C, Protein S and Antithrombin III were completed in all subjects.
All patients with idiopathic ONFH had bilateral hip involvement. The prevalence of thrombophilia in idiopathic ONFH was 32.5% (13/40). The protein C, protein S deficiencies, and increased factor VIII were the common types of abnormal coagulation in idiopathic ONFH.
Patients with idiopathic osteonecrosis of the femoral head had a high prevalence of thrombophilia at about 32.5% in contrast to 1-15% in the normal population. The present study suggested that thrombophilia maybe a risk factor of idiopathic osteonecrosis of the femoral head.
易栓症是指由于凝血系统异常而导致在静脉或动脉内形成血栓（血凝块）的倾向。它是股骨头坏死（ONFH）的病理生理原因之一。先前的研究表明，正常人群中易栓症的患病率为1%-15%。股骨头坏死有两种类型，原发性坏死（特发性坏死）和由其他已知病症引起的继发性坏死。此前尚无关于泰国特发性股骨头坏死患者中易栓症患病率的报道。
研究泰国特发性股骨头坏死患者中易栓症的患病率。
本研究纳入了55例股骨头坏死患者。其中40例为特发性坏死，15例为继发性坏死。所有受试者均完成了凝血因子V莱顿突变体、凝血因子VIII、蛋白C、蛋白S和抗凝血酶III的血液检查。
所有特发性ONFH患者均为双侧髋关节受累。特发性ONFH中易栓症的患病率为32.5%（13/40）。蛋白C、蛋白S缺乏以及凝血因子VIII升高是特发性ONFH中常见的异常凝血类型。
与正常人群1%-15%的患病率相比，特发性股骨头坏死患者中易栓症的患病率较高，约为32.5%。本研究表明，易栓症可能是特发性股骨头坏死的一个危险因素。
