Zhang Chang-Lie, Li Zun-Min, Song Zhi-Hong, Song Tao
Department of Vascular Surgery, Linyi People's Hospital, Linyi, Shandong, China.
Medicine (Baltimore). 2018 Jun;97(22):e10885. doi: 10.1097/MD.0000000000010885.
The purpose of this study was to explore the negative influence coagulation factor V (FV) 1691G>A polymorphism had on the risk and prognosis of lower extremity deep venous thrombosis (LDVT) in Chinese Han population.A total of 348 patients with LDVT (LDVT group) and 398 healthy individuals (control group) were selected to further this study. A polymerase chain reaction-restriction fragment length polymorphism method was used to analyze the FV gene 1691G>A polymorphism; coagulation and anticoagulation indexes of patients with LDVT were detected as a result. A 3-year follow-up and logistic regression analysis were conducted to determine the corresponding correlations between FV gene and LDVT.In comparison with the control group, the frequencies of GA and AA genotypes and A allele of 1691G>A polymorphism significantly increased in the LDVT group. Also, in comparison with patients with LDVT carrying GG genotype of FV gene 1691G>A polymorphism, the following activities reduced significantly: prothrombin time, activated partial thromboplastin time, fibrinogen, protein C, and protein S, while activated protein C resistance and lupus anticoagulant positive rate increased in patients carrying A allele (GA + AA). Logistic regression analysis indicated that FV gene 1691G>A polymorphism, total cholesterol, low-density lipoprotein cholesterol, and LDVT family histories were all closely related with LDVT and were subsequent independent risk factors for LDVT. Moreover, patients with LDVT carrying A allele (GA + AA) had both higher patency and recurrence rates than those carrying GG genotype.FV gene 1691G>A polymorphism may be associated with both the risk and prognosis of LDVT, potentially being a useful index for monitoring LDVT prognosis and risk.
本研究旨在探讨凝血因子V（FV）1691G>A多态性对中国汉族人群下肢深静脉血栓形成（LDVT）风险及预后的负面影响。本研究共选取348例LDVT患者（LDVT组）和398例健康个体（对照组）。采用聚合酶链反应-限制性片段长度多态性方法分析FV基因1691G>A多态性；检测LDVT患者的凝血和抗凝指标。进行3年随访及逻辑回归分析以确定FV基因与LDVT之间的相应相关性。与对照组相比，LDVT组中GA和AA基因型以及1691G>A多态性的A等位基因频率显著增加。此外，与携带FV基因1691G>A多态性GG基因型的LDVT患者相比，以下活性显著降低：凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、蛋白C和蛋白S，而携带A等位基因（GA+AA）的患者活化蛋白C抵抗和狼疮抗凝物阳性率增加。逻辑回归分析表明，FV基因1691G>A多态性、总胆固醇、低密度脂蛋白胆固醇和LDVT家族史均与LDVT密切相关，是LDVT后续的独立危险因素。此外，携带A等位基因（GA+AA）的LDVT患者通畅率和复发率均高于携带GG基因型的患者。FV基因1691G>A多态性可能与LDVT的风险和预后均相关，可能是监测LDVT预后和风险的有用指标。
