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65岁以下视网膜静脉阻塞患者的多种血栓形成风险标志物

[Multiple thrombophilic risk markers in patients ≺65 years of age with retinal vein occlusion].

作者信息

Kuhli-Hattenbach C, Hellstern P, Miesbach W, Kohnen T, Hattenbach L-O

机构信息

Klinik für Augenheilkunde, Klinikum der Goethe-Universität Frankfurt am Main, Frankfurt am Main, Deutschland.

Klinik für Hämostaseologie und Transfusionsmedizin, Klinikum Ludwigshafen, Ludwigshafen am Rhein, Deutschland.

出版信息

Ophthalmologe. 2017 Dec;114(12):1149-1154. doi: 10.1007/s00347-017-0456-4.

DOI:10.1007/s00347-017-0456-4
PMID:28185002
Abstract

BACKGROUND

The potential impact of multiple thrombophilic defects on retinal venous occlusive (RVO) diseases with regard to age and various risk factors has not been studied extensively.

MATERIALS AND METHODS

In a retrospective, multicenter study, thrombophilia data of 128 patients <65 years of age with RVO and 110 healthy subjects were evaluated. The main measure outcome was the prevalence of multiple thrombophilic disorders.

RESULTS

Multiple thrombophilic defects were significantly more prevalent among RVO patients (18.0%) than among controls (1.8%; P < 0.0001). We identified factor VIII elevation, elevated lipoprotein(a) plasma levels and resistance to activated protein C as the most prevalent combined disorders. Factor XII deficiency and prothrombin mutation G20210A were found to be isolated thrombophilic risk factors. Multiple thrombophilic defects were significantly associated with RVO recurrence (P = 0.008).

CONCLUSION

Multiple thrombophilic disorders are associated with the development of RVO among patients younger than 65 years of age. Moreover, our results suggest that patients with RVO associated with underlying combined thrombophilic defects are at increased risk for RVO recurrence. Further studies are required to analyze whether the diagnosis of combined thrombophilic defects among RVO patients could be a predictor for RVO recurrence.

摘要

背景

关于年龄和各种风险因素,多种血栓形成倾向缺陷对视网膜静脉阻塞(RVO)疾病的潜在影响尚未得到广泛研究。

材料与方法

在一项回顾性多中心研究中,对128例年龄<65岁的RVO患者和110名健康受试者的血栓形成倾向数据进行了评估。主要测量结果是多种血栓形成倾向疾病的患病率。

结果

RVO患者中多种血栓形成倾向缺陷的患病率(18.0%)显著高于对照组(1.8%;P<0.0001)。我们确定因子VIII升高、脂蛋白(a)血浆水平升高和对活化蛋白C的抵抗是最常见的合并疾病。发现因子XII缺乏和凝血酶原突变G20210A是孤立的血栓形成倾向危险因素。多种血栓形成倾向缺陷与RVO复发显著相关(P=0.008)。

结论

多种血栓形成倾向疾病与65岁以下患者的RVO发生有关。此外,我们的结果表明,伴有潜在合并血栓形成倾向缺陷的RVO患者RVO复发风险增加。需要进一步研究分析RVO患者合并血栓形成倾向缺陷的诊断是否可作为RVO复发的预测指标。

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本文引用的文献

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Acta Ophthalmol. 2017 Mar;95(2):140-145. doi: 10.1111/aos.13228. Epub 2016 Aug 22.
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The epidemiology of venous thromboembolism.静脉血栓栓塞症的流行病学
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Ophthalmologe. 2015 Aug;112(8):695-704; quiz 705-6. doi: 10.1007/s00347-015-0115-6.
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Low levels of plasma protein S, protein C and coagulation factor XII during early pregnancy and adverse pregnancy outcome.早孕期血浆蛋白 S、蛋白 C 和凝血因子 XII 水平降低与不良妊娠结局相关。
Thromb Haemost. 2015 Jul;114(1):65-9. doi: 10.1160/TH14-11-0928. Epub 2015 Apr 16.
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Ophthalmologe. 2015 Nov;112(11):929-31. doi: 10.1007/s00347-015-3234-1.
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Genetic variations associated with recurrent venous thrombosis.与复发性静脉血栓形成相关的基因变异
Circ Cardiovasc Genet. 2014 Dec;7(6):806-13. doi: 10.1161/CIRCGENETICS.114.000682. Epub 2014 Sep 10.
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Retinal vein occlusions: a review for the internist.视网膜静脉阻塞:内科医生的综述。
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