Vallejo-Villalobos Ma Fernanda, León-Peña Andrés, León-González Mónica, Núñez-Cortés Ana Karen, Olivares-Gazca Juan Carlos, Valdés-Tapia Patricia, Garcés-Eisele Javier, Ruiz-Argüelles Alejandro, Ruiz-Argüelles Guillermo J
Laboratorios Clínicos de Puebla, Puebla, Mexico.
Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico.
Indian J Hematol Blood Transfus. 2017 Sep;33(3):375-379. doi: 10.1007/s12288-016-0767-7. Epub 2016 Dec 19.
Activated protein C resistance (aPCR) phenotypes represent around 20% of the laboratory findings in Mexican Mestizos having suffered thrombosis and displaying clinical markers of thrombophilia. In a single institution for a 276-month period, 96 Mexican mestizos with a history of thrombosis and clinical markers of a primary thrombophilic state were prospectively studied to identify a thrombophilic condition. An abnormal aPCR phenotype was identified in 18 individuals. Evaluation of those with an abnormal aPCR phenotype, identified that 44% had factor V Leiden mutation, 22% increased levels of factor VIII, 16% anti-phospholipid antibodies and 6% a lupus anticoagulant. In the remaining 22%, the use of direct oral anticoagulants (DOACs) in the past period of 12-24 h was recorded. We found significant associations between abnormal aPCR phenotype and the factor V Leiden mutation ( = 0022), between abnormal aPCR phenotype and the use of DOACs ( = 0.006) and between antiphospholipid antibodies and lupus anticoagulant ( < 0.0001). These data are consonant with those observed in other populations and further identify that consideration be given to identifying whether individuals are being treated with the novel DOACs when conducting laboratory studies oriented to identify the etiology of thrombosis.
活化蛋白C抵抗（aPCR）表型约占墨西哥混血儿血栓形成实验室检查结果的20%，这些混血儿患有血栓形成并表现出血栓形成倾向的临床标志物。在一个单一机构进行的为期276个月的研究中，对96名有血栓形成病史且具有原发性血栓形成倾向临床标志物的墨西哥混血儿进行了前瞻性研究，以确定血栓形成倾向状况。在18名个体中发现了异常的aPCR表型。对具有异常aPCR表型的个体进行评估发现，44%有因子V莱顿突变，22%因子VIII水平升高，16%有抗磷脂抗体，6%有狼疮抗凝物。在其余22%的个体中，记录到在过去12 - 24小时内使用了直接口服抗凝剂（DOACs）。我们发现异常aPCR表型与因子V莱顿突变之间存在显著关联（P = 0.022），异常aPCR表型与DOACs的使用之间存在显著关联（P = 0.006），抗磷脂抗体与狼疮抗凝物之间也存在显著关联（P < 0.0001）。这些数据与在其他人群中观察到的数据一致，并进一步表明在进行旨在确定血栓形成病因的实验室研究时，应考虑确定个体是否正在接受新型DOACs治疗。
