Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, 819 Brinkhous-Bullitt Building, Chapel Hill, North Carolina 27599-7525, USA.
McAllister Heart Institute, University of North Carolina at Chapel Hill, USA.
Nat Rev Dis Primers. 2015 May 7;1:15006. doi: 10.1038/nrdp.2015.6.
Venous thromboembolism (VTE) encompasses deep-vein thrombosis (DVT) and pulmonary embolism. VTE is the leading cause of lost disability-adjusted life years and the third leading cause of cardiovascular death in the world. DVT leads to post-thrombotic syndrome, whereas pulmonary embolism can cause chronic pulmonary hypertension, both of which reduce quality of life. Genetic and acquired risk factors for thrombosis include non-O blood groups, factor V Leiden mutation, oral contraceptive use, hormone replacement therapy, advanced age, surgery, hospitalization and long-haul travel. A combination of blood stasis, plasma hypercoagulability and endothelial dysfunction is thought to trigger thrombosis, which starts most often in the valve pockets of large veins. Animal studies have revealed pathogenic roles for leukocytes, platelets, tissue factor-positive microvesicles, neutrophil extracellular traps and factors XI and XII. Diagnosis of VTE requires testing and exclusion of other pathologies, and typically involves laboratory measures (such as D-dimer) and diagnostic imaging. VTE is treated with anticoagulants and occasionally with thrombolytics to prevent thrombus extension and to reduce thrombus size. Anticoagulants are also used to reduce recurrence. New therapies with improved safety profiles are needed to prevent and treat venous thrombosis. For an illustrated summary of this Primer, visit: http://go.nature.com/8ZyCuY.
静脉血栓栓塞症（VTE）包括深静脉血栓形成（DVT）和肺栓塞。VTE 是全球丧失伤残调整生命年的主要原因，也是心血管死亡的第三大原因。DVT 可导致血栓后综合征，而肺栓塞可导致慢性肺动脉高压，两者均降低生活质量。血栓形成的遗传和获得性危险因素包括非 O 血型、因子 V Leiden 突变、口服避孕药使用、激素替代疗法、高龄、手术、住院和长途旅行。血液淤滞、血浆高凝状态和内皮功能障碍的联合作用被认为会引发血栓形成，血栓形成通常首先发生在大静脉的瓣膜窝中。动物研究揭示了白细胞、血小板、组织因子阳性微囊泡、中性粒细胞胞外诱捕网和因子 XI 和 XII 的致病作用。VTE 的诊断需要进行检查并排除其他病理情况，通常需要实验室检查（如 D-二聚体）和诊断性影像学检查。VTE 的治疗方法是使用抗凝剂，偶尔还使用溶栓剂来防止血栓延伸和减小血栓体积。抗凝剂也用于减少复发。需要具有改善安全性特征的新型疗法来预防和治疗静脉血栓。有关本《基础篇》的图文摘要，请访问：http://go.nature.com/8ZyCuY。
