Yildiz Abdulkerim, Güryildirim Melike, Pepeler Mehmet Sezgin, Yazol Merve, Oktar Suna Özhan, Acar Kadir
1 Faculty of Medicine, Department of Internal Medicine, Gazi University, Ankara, Turkey.
2 Faculty of Medicine, Department of Radiology, Gazi University, Ankara, Turkey.
Clin Appl Thromb Hemost. 2018 Oct;24(7):1102-1108. doi: 10.1177/1076029618766260. Epub 2018 Apr 22.
Thrombosis is the most important cardiovascular complication of classical myeloproliferative disorders (MPDs). Endothelial dysfunction (ED) is known to play a major role in the mechanism of thrombophilia in MPDs.
Endothelial dysfunction and its associations with other parameters were investigated. A total of 18 patients with polycythemia vera (PV), 24 with essential thrombocytosis (ET), 7 with primary myelofibrosis (PMF), and 30 healthy patients as a control group were included in the study. To assess the ED, flow-mediated dilatation (FMD) measurements were used.
The FMD (%) result showing ED was determined as 9.9 (0.0-21.6) in the patients with PV, 7.3 (0.0-30.5) in patients with ET, 7.5 (0.0-18.0) in patients with PMF, and 13.9 (6.2-26.7) in the control group. The FMD (%) was markedly impaired in all patients with MPD compared to the control patients (7.8 [0.0-30.5] vs 13.9 [6.15-26.8], P = .02). According to the disease subtypes, FMD (%) was significantly lower in the ET group than in the control group ( P = .01).
Endothelial function was assessed in patients with MPD having FMD and was determined to demonstrate ED. Lower FMD was associated with older age, leukocytosis, thrombocytosis, and thrombosis history.
血栓形成是经典骨髓增殖性疾病(MPD)最重要的心血管并发症。已知内皮功能障碍(ED)在MPD的血栓形成机制中起主要作用。
研究内皮功能障碍及其与其他参数的关联。本研究纳入了18例真性红细胞增多症(PV)患者、24例原发性血小板增多症(ET)患者、7例原发性骨髓纤维化(PMF)患者以及30例健康患者作为对照组。采用血流介导的血管舒张(FMD)测量来评估内皮功能障碍。
PV患者中显示内皮功能障碍的FMD(%)结果为9.9(0.0 - 21.6),ET患者为7.3(0.0 - 30.5),PMF患者为7.5(0.0 - 18.0),对照组为13.9(6.2 - 26.7)。与对照患者相比,所有MPD患者的FMD(%)均明显受损(7.8 [0.0 - 30.5] 对 13.9 [6.15 - 26.8],P = 0.02)。根据疾病亚型,ET组的FMD(%)显著低于对照组(P = 0.01)。
对采用FMD评估的MPD患者的内皮功能进行了评估,结果显示存在内皮功能障碍。较低的FMD与年龄较大、白细胞增多、血小板增多和有血栓形成病史相关。