静脉曲张患者的浅静脉血栓形成：血栓形成倾向因素、年龄和体重的作用。

Superficial vein thrombosis in patients with varicose veins: role of thrombophilia factors, age and body mass.

机构信息

Department of Vascular Surgery, University Hospital of Larissa, University of Thessalia, Larissa, Greece.

出版信息

Eur J Vasc Endovasc Surg. 2012 Mar;43(3):355-8. doi: 10.1016/j.ejvs.2011.12.019. Epub 2012 Jan 20.

DOI:10.1016/j.ejvs.2011.12.019

PMID:22264424

Abstract

OBJECTIVES

To investigate the association of various risk factors including thrombophilia defects, in patients with varicose veins (VVs) and history of episodes of superficial vein thrombosis (SVT).

MATERIALS AND METHODS

Two hundred and thirty patients with primary VVs were included in this prospective study. A total of 128 (43 men, age 56 ± 13) had an acute episode or a previous history of SVT, while 102 patients (27 men, age 48 ± 12) did not. Coagulation profile investigation included serum levels of protein C (PC), protein S (PS), anti-thrombin III (AT III), plasminogen (Plg), A(2) antiplasmin (A(2)Apl) and activated protein C resistance (APCR). This was performed at least 3 months after the SVT episode to ensure that the results were not altered. Age and body mass index (BMI) were also assessed.

RESULTS

PC deficiency was detected in 3/128 (2.3%), PS deficiency in 19/128 (14.8%), AT III deficiency in 29/128 (22.7%), Plg deficiency in 9/128 (7%), A(2)Apl excess in 3/128 (2.3%) and APCR in 9/128 (7%) patients with SVT and 0/102 (0%), 3/102 (2.9%), 15/102 (14.7%), 6/102 (5.8%), 0/102 (0%) and 1/102 (0.9%) in the control group, respectively. BMI greater than 30 kg m(-2) was associated with SVT. In logistic regression analysis SVT was associated with PS deficiency (odds ratio (OR) 6.7, p = 0.004, 95% confidence interval (CI) 1.83-24.53), obesity (OR 3.5, p = 0.003, 95% CI 1.53-8.05) and age (OR 1.038, p = 0.001, 95% CI 1.01-1.06).

CONCLUSIONS

Obesity, age and PS deficiency were found as factors associated with SVT episodes in patients with VVs.

摘要

目的

探讨包括血栓形成缺陷在内的各种危险因素与静脉曲张（VV）患者和浅静脉血栓形成（SVT）发作史之间的关系。

材料和方法

本前瞻性研究纳入了 230 例原发性 VV 患者。其中 128 例（43 名男性，年龄 56±13 岁）有急性发作或既往 SVT 病史，而 102 例（27 名男性，年龄 48±12 岁）无 SVT 病史。凝血谱检查包括血清蛋白 C（PC）、蛋白 S（PS）、抗凝血酶 III（AT III）、纤溶酶原（Plg）、A2 抗纤溶酶（A2Apl）和活化蛋白 C 抵抗（APCR）。这些检查至少在 SVT 发作后 3 个月进行，以确保结果不会改变。还评估了年龄和体重指数（BMI）。

结果

在有 SVT 的 128 例患者中，检测到 3 例（2.3%）PC 缺乏、19 例（14.8%）PS 缺乏、29 例（22.7%）AT III 缺乏、9 例（7%）Plg 缺乏、3 例（2.3%）A2Apl 过多和 9 例（7%）APCR，而在 102 例对照患者中分别为 0/102（0%）、3/102（2.9%）、15/102（14.7%）、6/102（5.8%）、0/102（0%）和 1/102（0.9%）。BMI 大于 30kg/m2 与 SVT 相关。在逻辑回归分析中，SVT 与 PS 缺乏（比值比（OR）6.7，p=0.004，95%置信区间（CI）1.83-24.53）、肥胖（OR 3.5，p=0.003，95%CI 1.53-8.05）和年龄（OR 1.038，p=0.001，95%CI 1.01-1.06）相关。