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深静脉血栓形成患者与对照组中血栓前危险因素的频率:其对智利人群血栓形成倾向筛查的意义。

Frequency of prothrombotic risk factors in patients with deep venous thrombosis and controls: their implications for thrombophilia screening in Chilean subjects.

作者信息

Guzmán Neftalí, Salazar Luis A

机构信息

Departamento de Ciencias Básicas, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.

出版信息

Genet Test Mol Biomarkers. 2010 Oct;14(5):599-602. doi: 10.1089/gtmb.2010.0012. Epub 2010 Aug 14.

Abstract

In this work, we evaluated the frequency of prothrombotic defects associated with deep venous thrombosis (DVT) in southern Chilean subjects. A total of 261 individuals, 87 patients with DVT confirmed by Doppler ultrasonography and 174 controls, were included in this study. Factor V and factor VIII levels, activated protein C (APC) resistance, and lupus anticoagulant detection were assayed by clotting methods. Basal homocysteine was quantified by immunoassay, and the polymorphisms in factor V (F5), methylenetetrahydrofolate reductase (MTHFR), and cystathionine β-synthase (CBS) genes were genotyped by molecular methods. The most frequent defects were APC resistance, hyperhomocysteinemia, and increased levels of factor VIII. We observed a complete absence of the F5 G1691A variant in the studied population, and the frequency of MTHFR C677T polymorphism was significantly different between patients and controls (odds ratio = 3.2; 95% confidence interval, 1.513-6.735; p = 0.016). In addition, subjects carrying the homozygous MTHFR 677TT genotype exhibited higher levels of plasma homocysteine. Our data suggest that the APC resistance is the most important defect in Chilean patients with DVT. However, this phenotype is not associated with the presence of the F5 G1691A variant. In addition, only MTHFR C677T polymorphism constituted a molecular biomarker of DVT in Chilean population.

摘要

在本研究中,我们评估了智利南部人群中与深静脉血栓形成(DVT)相关的血栓前状态缺陷的发生率。本研究共纳入261名个体,其中87例经多普勒超声确诊为DVT的患者和174名对照者。采用凝血方法检测因子V和因子VIII水平、活化蛋白C(APC)抵抗以及狼疮抗凝物。采用免疫测定法定量基础同型半胱氨酸,并通过分子方法对因子V(F5)、亚甲基四氢叶酸还原酶(MTHFR)和胱硫醚β-合成酶(CBS)基因的多态性进行基因分型。最常见的缺陷是APC抵抗、高同型半胱氨酸血症和因子VIII水平升高。我们在所研究的人群中未观察到F5 G1691A变体,并且患者与对照者之间MTHFR C677T多态性的频率存在显著差异(优势比 = 3.2;95%置信区间,1.513 - 6.735;p = 0.016)。此外,携带纯合MTHFR 677TT基因型的受试者血浆同型半胱氨酸水平较高。我们的数据表明,APC抵抗是智利DVT患者中最重要的缺陷。然而,这种表型与F5 G1691A变体的存在无关。此外,仅MTHFR C677T多态性构成智利人群DVT的分子生物标志物。

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