Konanki Ramesh, Gulati Sheffali, Saxena Renu, Gupta Arun Kumar, Seith Ashu, Kumar Ashok, Saxena Anita, Kabra Madhulika, Kalra Veena, Lakshmy Ramakrishnan
Rainbow Hospital for Women and Children, Banjara Hills, Hyderabad, India; Division of Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar, New Delhi 110029, India.
Division of Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar, New Delhi 110029, India.
J Clin Neurosci. 2014 Aug;21(8):1315-8. doi: 10.1016/j.jocn.2013.10.030. Epub 2014 Jan 27.
This study was undertaken in view of paucity of data regarding the profile of prothrombotic factors in children with ischemic stroke. Sixty-four children with ischemic stroke were prospectively evaluated for prothrombotic factors over a 2 year period. The blood samples were analyzed for protein C (PC), protein S (PS), activated protein C resistance (APCR), factor V Leiden (FVL), anti-thrombin-III (AT-III), lipoprotein (a) [Lp(a)], lupus anticoagulant (LA), anti-cardiolipin antibodies (aCL) immunoglobulin (Ig) M and IgG, homocysteine, and methylenetetrahydrofolate reductase (MTHFR) at least 3 months after the onset of stroke. At least one prothrombotic factor was identified in 45.3% children (29/64). These included hyperhomocysteinemia (11/64), PC deficiency (9/64), aCL (8/64), PS deficiency (5/64), APCR (3/64), AT-III deficiency (2/64) and LA (1/64). Multiple factors were coexistent in 17.2% (11/64). The prevalence of PC deficiency, PS deficiency and co-existence of multiple abnormalities observed were similar to the published literature. Elevated Lp(a) and APCR were less prevalent. FVL and MTHFR were not seen in any of the study children. Forty-five percent of children had at least one prothrombotic abnormality. Hyperhomocysteinemia, PC deficiency, aCL and PS deficiency were the most frequent prothrombotic abnormalities.
鉴于关于缺血性中风患儿血栓前状态因素概况的数据匮乏，开展了本研究。在2年期间，对64例缺血性中风患儿进行了血栓前状态因素的前瞻性评估。在中风发病至少3个月后，对血样进行蛋白C（PC）、蛋白S（PS）、活化蛋白C抵抗（APCR）、凝血因子V莱顿（FVL）、抗凝血酶III（AT-III）、脂蛋白（a）[Lp（a）]、狼疮抗凝物（LA）、抗心磷脂抗体（aCL）免疫球蛋白（Ig）M和IgG、同型半胱氨酸以及亚甲基四氢叶酸还原酶（MTHFR）分析。45.3%的患儿（29/64）被鉴定出至少一种血栓前状态因素。这些因素包括高同型半胱氨酸血症（11/64）、PC缺乏（9/64）、aCL（8/64）、PS缺乏（5/64）、APCR（3/64）、AT-III缺乏（2/64）和LA（1/64）。17.2%（11/64）的患儿存在多种因素并存的情况。观察到的PC缺乏、PS缺乏以及多种异常并存的患病率与已发表的文献相似。Lp（a）升高和APCR的患病率较低。在所有研究患儿中均未发现FVL和MTHFR。45%的患儿至少有一种血栓前异常。高同型半胱氨酸血症、PC缺乏、aCL和PS缺乏是最常见的血栓前异常。
