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遗传性血栓前状态对糖尿病患者经皮腔内血管成形术长期临床结局的影响。

Impact of Inherited Prothrombotic Disorders on the Long-Term Clinical Outcome of Percutaneous Transluminal Angioplasty in Patients with Diabetes.

作者信息

Dubský Michal, Jirkovská Alexandra, Pagáčová Libuše, Bém Robert, Němcová Andrea, Fejfarová Vladimíra, Wosková Veronika, Jude Edward B

机构信息

Diabetes Centre, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic.

Diabetes Centre, Tameside Hospital NHS Foundation Trust and University of Manchester, Ashton-Under-Lyne OL6 9RW, UK.

出版信息

J Diabetes Res. 2015;2015:369758. doi: 10.1155/2015/369758. Epub 2015 Jul 13.

Abstract

The aim of our study was to analyse inherited thrombotic disorders that influence the long-term outcome of PTA. Methods. Diabetic patients with peripheral arterial disease (PAD) treated by PTA in our centre between 2008 and 2011 were included in the study. Patients were divided into unsuccessful PTA group (75 patients), successful PTA group (58 patients), and control group (65 patients, with diabetes but no PAD). Diagnosis of inherited thrombotic disorders included mutation in factor V (Leiden), factor II (prothrombin), and mutation in genes for methylenetetrahydrofolate reductase-MTHFR (C677T and A1298C). Results. The genotypic frequency of Leiden allele G1691A was significantly associated with a risk of unsuccessful PTA in comparison with successful PTA group and control group (OR 8.8 (1.1-70.6), p = 0.041, and OR 9.8 (1.2-79.2), p = 0.032, resp.). However, we only observed a trend for the association of the prothrombin allele G20210A and risk of PTA failure. The frequencies of alleles of MTHFR 677 or 1298 did not differ significantly among the groups. Conclusion. Our study showed higher frequency of heterozygous form of Leiden mutation in diabetic patients with unsuccessful outcome of PTA in comparison with patients with successful PTA and diabetic patients without PAD.

摘要

我们研究的目的是分析影响经皮腔内血管成形术(PTA)长期疗效的遗传性血栓形成障碍。方法。2008年至2011年期间在我们中心接受PTA治疗的外周动脉疾病(PAD)糖尿病患者被纳入研究。患者被分为PTA治疗失败组(75例患者)、PTA治疗成功组(58例患者)和对照组(65例患者,患有糖尿病但无PAD)。遗传性血栓形成障碍的诊断包括因子V(Leiden)、因子II(凝血酶原)的突变以及亚甲基四氢叶酸还原酶-MTHFR(C677T和A1298C)基因的突变。结果。与PTA治疗成功组和对照组相比,Leiden等位基因G1691A的基因型频率与PTA治疗失败风险显著相关(分别为OR 8.8(1.1-70.6),p = 0.041和OR 9.8(1.2-79.2),p = 0.032)。然而,我们仅观察到凝血酶原等位基因G20210A与PTA失败风险之间存在关联趋势。MTHFR 677或1298等位基因频率在各组之间无显著差异。结论。我们的研究表明,与PTA治疗成功的患者和无PAD的糖尿病患者相比,PTA治疗失败的糖尿病患者中Leiden突变杂合形式的频率更高。

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