1Cholesterol Center, Jewish Hospital of Cincinnati, Cincinnati, OH, USA.
Clin Appl Thromb Hemost. 2013 Sep;19(5):499-503. doi: 10.1177/1076029612449901. Epub 2012 Jun 12.
We examined the hypothesis that the factor V Leiden (FVL) and G20101A prothrombin gene mutations are commonly associated with hip osteonecrosis. We prospectively evaluated 244 consecutively referred adults with osteonecrosis (ON), 161 idiopathic and 83 secondary. Cases (n = 244) did not differ from 104 normal controls by race. Of the 244 patients, 23 (9.4%) were FVL heterozygotes versus 2 of 104 controls (1.9%), P = .013, risk ratio (RR) = 4.90, 95% confidence interval (CI) 1.18 to 20.4. Of the 161 patients with idiopathic ON, 15 (9.3%) were FVL heterozygotes versus 2 of 104 normal controls (1.9%), P = .017, RR = 4.84, 95% CI 1.13 to 20.8. Of the 83 patients with secondary ON, 8 (9.6%) FVL heterozygotes versus 2 of 104 normal controls (1.9%), P = .024, RR = 5.01, 95% CI 1.09 to 23.0. Prothrombin gene heterozygosity in normal controls (2.9%) did not differ from ON cases (3.4%), P = 1.0. The thrombophilic FVL mutation is commonly associated with and may be pathoetiologic for hip osteonecrosis.
我们检验了因子 V 莱顿（FVL）和凝血酶原基因 G20101A 突变是否与髋部骨坏死普遍相关的假说。我们前瞻性地评估了 244 例连续就诊的骨坏死（ON）患者，其中 161 例为特发性，83 例为继发性。病例（n=244）在种族上与 104 名正常对照者无差异。在 244 例患者中，23 例（9.4%）为 FVL 杂合子，而 104 例正常对照者中有 2 例（1.9%），P=.013，风险比（RR）=4.90，95%可信区间（CI）为 1.18 至 20.4。在 161 例特发性 ON 患者中，15 例（9.3%）为 FVL 杂合子，而 104 例正常对照者中有 2 例（1.9%），P=.017，RR=4.84，95%CI 为 1.13 至 20.8。在 83 例继发性 ON 患者中，8 例（9.6%）为 FVL 杂合子，而 104 例正常对照者中有 2 例（1.9%），P=.024，RR=5.01，95%CI 为 1.09 至 23.0。正常对照者（2.9%）的凝血酶原基因杂合子与 ON 病例（3.4%）无差异，P=1.0。血栓形成倾向的 FVL 突变与髋部骨坏死普遍相关，并且可能是其发病机制。
