Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Semin Thromb Hemost. 2013 Nov;39(8):913-27. doi: 10.1055/s-0033-1357504. Epub 2013 Oct 15.
Cerebral venous thrombosis (CVT) is a rare manifestation of venous thromboembolism (VTE) and stroke. The aim of our systematic review was to provide an updated summary of the strength of association between CVT and thrombophilia and to explore the relevance of thrombophilia for recurrence of CVT or other VTE, or other outcome variables. MEDLINE (via PubMed), EMBASE (via Ovid), and CENTRAL were systematically searched, including references of retrieved articles. Cohort studies of ≥ 40 patients and case-control studies comparing the prevalence of thrombophilia in patients with CVT and unrelated controls were eligible. Two reviewers independently selected studies, assessed quality, and extracted data. A meta-analysis was performed for high quality case-control studies with unselected cases and healthy controls. Odds ratios with 95% confidence intervals were calculated and pooled. We included 23 cohort studies and 33 case-control studies. A significant association was demonstrated between CVT and all inherited thrombophilic factors, as well as increased levels of homocysteine. Inconclusive results were found on the relevance of thrombophilia for recurrent CVT or other VTE. Although there is a strong association between CVT and thrombophilia, the clinical relevance of thrombophilia testing in patients with CVT seems limited, similarly to other forms of VTE.
脑静脉血栓形成（CVT）是静脉血栓栓塞症（VTE）和中风的一种罕见表现。我们的系统评价旨在提供 CVT 与血栓形成倾向之间关联强度的最新总结，并探讨血栓形成倾向对 CVT 或其他 VTE 复发或其他结局变量的相关性。系统地检索了 MEDLINE（通过 PubMed）、EMBASE（通过 Ovid）和 CENTRAL，并检索了已检索文章的参考文献。符合条件的研究包括≥40 例患者的队列研究和比较 CVT 患者与无相关对照者血栓形成倾向患病率的病例对照研究。两名审查员独立选择研究、评估质量并提取数据。对无选择性病例和健康对照的高质量病例对照研究进行了荟萃分析。计算并汇总了比值比及其 95%置信区间。我们纳入了 23 项队列研究和 33 项病例对照研究。CVT 与所有遗传性血栓形成倾向因子以及同型半胱氨酸水平升高均存在显著相关性。血栓形成倾向对 CVT 或其他 VTE 复发的相关性尚无定论。尽管 CVT 与血栓形成倾向之间存在很强的关联，但血栓形成倾向检测在 CVT 患者中的临床相关性似乎有限，与其他形式的 VTE 相似。
