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墨西哥原发性血栓形成倾向研究之十二:血小板黏附综合征患者流产更为常见。

Primary Thrombophilia in Mexico XII: Miscarriages Are More Frequent in People with Sticky Platelet Syndrome.

作者信息

Ruiz-Delgado Guillermo J, Cantero-Fortiz Yahveth, Mendez-Huerta Mariana A, Leon-Gonzalez Mónica, Nuñez-Cortes Ana K, Leon-Peña Andrés A, Olivares-Gazca Juan Carlos, Ruiz-Argüelles Guillermo J

机构信息

Centro de Hematología y Medicina Interna de Puebla, Puebla, Mexico.

出版信息

Turk J Haematol. 2017 Aug 2;34(3):239-243. doi: 10.4274/tjh.2016.0411. Epub 2017 Feb 9.

Abstract

OBJECTIVE

Sticky platelet syndrome (SPS) is an inherited condition that leads to arterial and venous thrombosis. There is scant information about the association between SPS and obstetric complications. This study aimed to assess the relationship between SPS and fetal loss at a single institution.

MATERIALS AND METHODS

The obstetric histories of all consecutive female patients prospectively studied in a 324-month period at a single institution with a history of thrombosis and a clinical marker of primary thrombophilia were reviewed.

RESULTS

Between 1989 and 2016, 268 consecutive patients with a clinical marker of primary thrombophilia and a history of arterial or venous thrombosis were studied; of these, 108 were female patients. Within this subset of thrombophilic females, 77 (71%) had been pregnant at some point. Twenty-eight of these 77 patients (37%) had had a spontaneous abortion and 24 of those (86%) were found to have SPS. On the other hand, in a subset of 73 female patients with SPS who had been pregnant, 32% had miscarriages. These figures are significantly higher than the prevalence of spontaneous abortions in the general Mexican population of pregnant women, which is 12%-13% (chi-square: 7.47; p=0.0063). Accordingly, the relative risk of having a miscarriage is 2.66 times higher in female patients with SPS than in the general population (p=0.0014).

CONCLUSION

In Mexico, female patients with SPS experience significantly more spontaneous abortions than the general population. Since the treatment of SPS is simple and effective and could in turn prevent adverse obstetric outcomes, its investigation in women treated for obstetric complications may be useful and deserves further research.

摘要

目的

黏附性血小板综合征(SPS)是一种遗传性疾病,可导致动静脉血栓形成。关于SPS与产科并发症之间的关联,目前信息匮乏。本研究旨在评估单一机构中SPS与胎儿丢失之间的关系。

材料与方法

回顾了在单一机构对所有连续女性患者进行的324个月前瞻性研究的产科病史,这些患者有血栓形成史且有原发性易栓症的临床指标。

结果

1989年至2016年期间,对268例有原发性易栓症临床指标且有动静脉血栓形成史的连续患者进行了研究;其中108例为女性患者。在这些易栓症女性亚组中,77例(71%)曾在某个时候怀孕。这77例患者中有28例(37%)发生过自然流产,其中24例(86%)被发现患有SPS。另一方面,在73例怀孕的SPS女性患者亚组中,32%发生过流产。这些数字显著高于墨西哥普通孕妇人群中自然流产的发生率,即12%-13%(卡方检验:7.47;p=0.0063)。因此,SPS女性患者流产的相对风险比普通人群高2.66倍(p=0.0014)。

结论

在墨西哥,SPS女性患者发生自然流产的情况显著多于普通人群。由于SPS的治疗简单有效,进而可以预防不良产科结局,因此对有产科并发症的女性进行SPS调查可能是有用的,值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27d5/5544043/92783e5fdcaf/TJH-34-239-g2.jpg

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