Department of Medicine, Dartmouth-Hitchcock Medical Center Lebanon, NH, USA.
Clin Appl Thromb Hemost. 2013 Jul-Aug;19(4):363-6. doi: 10.1177/1076029612460425. Epub 2012 Sep 23.
To investigate an association between secondary polycythemia and venous thromboembolism (VTE) risk, we performed a case-control study to compare the prevalence of VTE in participants with secondary polycythemia due to chronic obstructive pulmonary disease (COPD; N = 86) to that in age- and sex-matched controls with COPD without secondary polycythemia (N = 86). Although there was a significant difference in mean hematocrit between cases and controls (53.5% vs 43.6%, respectively; P < .005), we identified no difference in the number of total or idiopathic VTE events in the 2 groups. Patients with VTE, however, had a significantly higher body mass index than patients without VTE. Our findings suggest that secondary polycythemia alone may not be a significant risk factor for VTE but that VTE risk in this population may be related to known risk factors such as obesity. The role of phlebotomy for VTE risk reduction secondary polycythemia is therefore questionable.
为了研究继发性红细胞增多症与静脉血栓栓塞症(VTE)风险之间的关联,我们进行了一项病例对照研究,比较了因慢性阻塞性肺疾病(COPD)导致的继发性红细胞增多症患者(N=86)与年龄和性别匹配的无继发性红细胞增多症 COPD 患者(N=86)中 VTE 的患病率。尽管病例组和对照组的平均血细胞比容存在显著差异(分别为 53.5%和 43.6%;P<.005),但我们未发现两组总 VTE 或特发性 VTE 事件的数量存在差异。然而,患有 VTE 的患者的体重指数明显高于未患有 VTE 的患者。我们的研究结果表明,单纯的继发性红细胞增多症可能不是 VTE 的重要危险因素,但该人群的 VTE 风险可能与肥胖等已知危险因素有关。因此,放血疗法降低继发性红细胞增多症相关 VTE 风险的作用尚存在争议。