Jezovnik Mateja Kaja, Fareed Jawed, Poredos Pavel
1 University of Texas Health Science Center at Houston, Houston, TX, USA.
2 Hemostasis and Thrombosis Research Laboratories, Loyola University Medical Center, Maywood, IL, USA.
Clin Appl Thromb Hemost. 2017 Mar;23(2):124-131. doi: 10.1177/1076029616670259. Epub 2016 Sep 24.
Although the role of inflammation in DVT has been investigated in different studies, there is no definite answer as to whether increased systemic inflammation is the cause or the consequence of DVT.
To follow inflammatory parameters in a cohort of patients with idiopathic DVT.
Out of 49 patients with an acute idiopathic DVT, which were investigated four months after an acute episode (DEVTA 1), 43 patients were included in the follow-up study investigating inflammatory markers and hemostatic markers of endothelial damage five years after an acute DVT (DEVTA 2). A control group consisted of 43 sex and age matched healthy subjects (CONTROLS).
The levels of inflammatory markers were significantly higher in DEVTA 2 in comparison to CONTROLS: tumor necrosis factor alpha 2.0 pg/mL (1.1-2.3) vs 1.3 pg/mL (0.8-1.9), p < .001, high sensitivity C-reactive protein 3.2 mg/L (1.5-5.2) vs 1.7 mg/L (0.9-3.0), p = .008, interleukin-6 (IL-6) 2.7 pg/mL (2.0-3.5) vs 2.1 pg/mL (1.5-2.6), p = .025, IL-8 5.0 pg/mL (3.6-7.3) vs 2.4 pg/mL (1.8-2.8), p < .001. IL-10 was significantly decreased (0.9 pg/mL (0.7-1.8) vs 1.8 (1.5-2.2), p < .001. Most of the proinflammatory markers remained elevated in the DEVTA 2 in comparison to DEVTA 1. Markers of endothelial damage were higher in DEVTA 2 in comparison to CONTROLS and higher than in DEVTA 1.
Patients with idiopathic DVT have long-term increased inflammatory markers and markers of endothelial damage. These findings favor the hypothesis that inflammation is a cause and not merely a consequence of acute DVT.
尽管不同研究已对炎症在深静脉血栓形成(DVT)中的作用进行了调查,但对于全身炎症增加是DVT的原因还是结果,尚无明确答案。
追踪特发性DVT患者队列中的炎症参数。
在49例急性特发性DVT患者中,于急性发作后4个月进行调查(DEVTA 1),其中43例患者纳入随访研究,在急性DVT发作5年后调查炎症标志物和内皮损伤的止血标志物(DEVTA 2)。对照组由43名年龄和性别匹配的健康受试者组成(CONTROLS)。
与CONTROLS相比,DEVTA 2中的炎症标志物水平显著更高:肿瘤坏死因子α为2.0 pg/mL(1.1 - 2.3),而CONTROLS为1.3 pg/mL(0.8 - 1.9),p <.001;高敏C反应蛋白为3.2 mg/L(1.5 - 5.2),而CONTROLS为1.7 mg/L(0.9 - 3.0),p =.008;白细胞介素 - 6(IL - 6)为2.7 pg/mL(2.0 - 3.5),而CONTROLS为2.1 pg/mL(1.5 - 2.6),p =.025;IL - 8为5.0 pg/mL(3.6 - 7.3),而CONTROLS为2.4 pg/mL(1.8 - 2.8),p <.001。IL - 10显著降低(0.9 pg/mL(0.7 - 1.8),而CONTROLS为1.8(1.5 - 2.2),p <.001。与DEVTA 1相比,DEVTA 2中的大多数促炎标志物仍处于升高状态。与CONTROLS相比,DEVTA 2中的内皮损伤标志物更高,且高于DEVTA 1。
特发性DVT患者长期存在炎症标志物和内皮损伤标志物升高。这些发现支持炎症是急性DVT的原因而非仅仅是结果这一假说。