Sawant Prabha, Vashishtha Chitranshu, Nasa Mukesh, Parikh Pathik, Patel Jignesh, Agasti Ananta
Professor and Head.
Resident, Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai.
J Assoc Physicians India. 2015 Sep;63(9):32-5.
To estimate the prevalence of inherited prothrombotic risk factors in patients with splanchnic venous thrombosis (SVT) and Budd-Chiari syndrome (BCS) and to compare the risk factor profiles between these two groups.
In this prospective study, patients with abdominal venous thrombosis were studied. The patients were divided into two groups on the basis of the veins involved; splanchnic venous thrombosis group [portal (PVT), splenic, superior mesenteric veins (SMV)] and Budd-Chiari group (hepatic vein, IVC thrombosis). Thrombophilia profile including protein C, protein S, antithrombin III, factor V Leiden mutation, activated protein C, factor VIII level, CD55, CD59, IgM cardiolipin, IgG cardiolipin, anti-β2 glycoprotein, JAK2 mutation, homocysteine levels, MTHFR and lupus anticoagulant was done in all patients.
Out of 30 patients, 23 patients had SVT, 7 had BCS, including 2 of the 23 patients with SVT had mixed venous thrombosis, PVT and SMV thrombosis. Risk factors were found in 21/30 (70%) patients [17/23 (73.9%) of PVT. 4/7 (57.1% of BCS] and multiple risk factors were overall present in 8/23(34.7%) patients of SVT.
Hereditary risk factors play an important role in the etiopathogenesis of abdominal venous thrombosis and hyperhomocysteinemia and protein S deficiency are the most common risk factors.
评估内脏静脉血栓形成(SVT)和布加综合征(BCS)患者遗传性血栓形成风险因素的患病率,并比较这两组患者的风险因素谱。
在这项前瞻性研究中,对腹部静脉血栓形成患者进行了研究。根据受累静脉将患者分为两组;内脏静脉血栓形成组[门静脉(PVT)、脾静脉、肠系膜上静脉(SMV)]和布加综合征组(肝静脉、下腔静脉血栓形成)。对所有患者进行了血栓形成倾向分析,包括蛋白C、蛋白S、抗凝血酶III、因子V莱顿突变、活化蛋白C、因子VIII水平、CD55、CD59、IgM心磷脂、IgG心磷脂、抗β2糖蛋白、JAK2突变、同型半胱氨酸水平、亚甲基四氢叶酸还原酶(MTHFR)和狼疮抗凝物。
30例患者中,23例患有SVT,7例患有BCS,其中23例SVT患者中有2例为混合性静脉血栓形成,即PVT和SMV血栓形成。在21/30(70%)的患者中发现了风险因素[PVT患者中有17/23(73.9%),BCS患者中有4/7(57.1%)],并且在SVT患者的8/23(34.7%)中总体存在多种风险因素。
遗传风险因素在腹部静脉血栓形成的发病机制中起重要作用,高同型半胱氨酸血症和蛋白S缺乏是最常见的风险因素。