Boroujeni Hamid Rouhi, Pourgheysari Batoul, Hasheminia Alimohammad, Boroujeni Parnia Rouhi, Drees Fatima
Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran ; Department of Internal Medicine, Pulmonology Ward, Shahrekord University of Medical Sciences, Shahrekord, Iran ; School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran ; Department of Pathology and Hematology, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Tanaffos. 2014;13(3):14-22.
Pulmonary thromboembolism (PTE) is among the leading causes of death following surgery and/or hospital admission. Role of thrombophilic risk factors in the etiology of PTE is well known; But not much data is available on their role in severity of PTE. The aim of this study was to investigate the role of thrombotic risk factors especially PLA2 polymorphism of platelet glycoprotein IIb/IIIa in the severity of PTE.
Genotyping from Factor-V (FVL) and prothrombin 20210A (PT20210A) mutations were shown to be significant risk factors for PTE and recurrent PTE. The plasma concentrations of platelet glycoprotein IIb/IIIa PLA2 polymorphism, presence of FVL and PT20210A mutations were studied in 37 patients with PTE.
Eleven of these patients had recurrent PTE. Lung perfusion scans were scored according to the percentage of vascular obstruction. Patients who had a pulmonary vascular obstruction (PVO) score >50%were compared to those with PVO score<50%. There was no significant difference between patients with PVO score>50% and those with PVO score<50% with regard to the presence of FVL and PT20210A mutations. However, patients with PVO score>50% had a significantly higher frequency of platelet glycoprotein IIb/IIIaPLA2 polymorphism than those with PVO score <50%.
Our data suggest that presence of PLA2 is associated with an increased risk of PTE in the Iranian population. The association between recurrent events and coinheritance of more than one thrombophilic genetic risk factor shows that such carriers are at a higher risk of PTE.
肺血栓栓塞症（PTE）是手术和/或住院后主要的死亡原因之一。血栓形成风险因素在PTE病因中的作用已广为人知；但关于它们在PTE严重程度方面的作用，可用数据不多。本研究的目的是调查血栓形成风险因素，尤其是血小板糖蛋白IIb/IIIa的PLA2多态性在PTE严重程度中的作用。
因子V（FVL）和凝血酶原20210A（PT20210A）突变的基因分型被证明是PTE和复发性PTE的重要风险因素。对37例PTE患者研究了血小板糖蛋白IIb/IIIa PLA2多态性的血浆浓度、FVL和PT20210A突变的存在情况。
这些患者中有11例发生复发性PTE。根据血管阻塞百分比对肺灌注扫描进行评分。将肺血管阻塞（PVO）评分>50%的患者与PVO评分<50%的患者进行比较。在FVL和PT20210A突变的存在方面，PVO评分>50%的患者与PVO评分<50%的患者之间没有显著差异。然而，PVO评分>50%的患者血小板糖蛋白IIb/IIIa PLA2多态性的频率明显高于PVO评分<50%的患者。
我们的数据表明，PLA2的存在与伊朗人群中PTE风险增加有关。复发性事件与一种以上血栓形成遗传风险因素的共同遗传之间的关联表明，此类携带者发生PTE的风险更高。
