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报告的接触相凝血因子缺乏症病例中血栓形成的比较发生率。

Comparative incidence of thrombosis in reported cases of deficiencies of factors of the contact phase of blood coagulation.

机构信息

Department of Medical and Surgical Sciences, University of Padua Medical School, Via Ospedale 105, 35128 Padua, Italy.

出版信息

J Thromb Thrombolysis. 2011 Jan;31(1):57-63. doi: 10.1007/s11239-010-0495-z.

Abstract

Thrombotic manifestations occurring in patients with coagulation defects have drawn considerable attention during the last decade. It concerned mainly patients with hemophilia, vW disease or FVII deficiency. Occasional reports involved also the deficiencies of the contact phase of blood coagulation, mainly FXII deficiency. The purpose of the present study was to evaluate the comparative incidence of thrombosis in all reported patients with FXII, Prekallikrein and Kininogens deficiencies. Out of the reported 341 cases with these conditions that could be tracked there were 43 cases with thrombosis. More specifically, there were 32 patients with FXII deficiency who also had a thrombotic event (16 arterial and 16 venous). As far as Prekallikrein deficiency is concerned, there were nine cases with thrombosis (five arterial and four venous). Finally, two patients with Total or High molecular weight Kininogen deficiencies had also a thrombotic manifestation (one arterial and one venous). The thrombotic manifestations were M.I. 11 cases; ischemic stroke 9 cases; peripheral arteries 3 cases; deep vein thrombosis with or without pulmonary embolism 17 cases; thrombosis in other veins 3 cases. Congenital or acquired associated prothrombotic risk factors were present in 33 out of 36 cases. In three cases the existence of associated risk factors was excluded whereas in the remaining seven patients no mention is made in this regard. This study clearly indicates that the severe in vitro coagulation defect seen in these conditions does not protect from thrombosis.

摘要

在过去的十年中,凝血缺陷患者的血栓形成表现引起了相当大的关注。这主要涉及血友病、血管性血友病或 FVII 缺乏症患者。偶尔也有涉及接触相凝血缺陷的报告,主要是 FXII 缺乏症。本研究的目的是评估所有报道的 FXII、Prekallikrein 和激肽原缺乏症患者的血栓形成发生率。在可以追踪到的 341 例报告病例中,有 43 例有血栓形成。更具体地说,有 32 例 FXII 缺乏症患者发生了血栓形成事件(16 例动脉和 16 例静脉)。至于 Prekallikrein 缺乏症,有 9 例发生血栓形成(5 例动脉和 4 例静脉)。最后,2 例总或高分子量激肽原缺乏症患者也有血栓形成表现(1 例动脉和 1 例静脉)。血栓形成表现为心肌梗死 11 例;缺血性脑卒中 9 例;外周动脉 3 例;深静脉血栓形成伴或不伴肺栓塞 17 例;其他静脉血栓形成 3 例。在 36 例中有 33 例存在先天性或获得性的血栓形成倾向危险因素。在 3 例中排除了相关危险因素的存在,而在其余 7 例中没有提到这一点。这项研究清楚地表明,这些情况下体外严重的凝血缺陷并不能防止血栓形成。

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