Salvagno Gian Luca, Pavan Chiara, Lippi Giuseppe
Section of Clinical Biochemistry, University of Verona, Verona, Italy.
Division of Geriatric Medicine, Mater Salutis Hospital, Legnago, Verona, Italy.
Ann Transl Med. 2018 Sep;6(17):342. doi: 10.21037/atm.2018.08.12.
Thrombophilia, either acquired or inherited, can be defined as a predisposition to developing thromboembolic complications. Since the discovery of antithrombin deficiency in the 1965, many other conditions have been described so far, which have then allowed to currently detect an inherited or acquired predisposition in approximately 60-70% of patients with thromboembolic disorders. These prothrombotic risk factors mainly include qualitative or quantitative defects of endogenous coagulation factor inhibitors, increased concentration or function of clotting proteins, defects in the fibrinolytic system, impaired platelet function, and hyperhomocysteinemia. In this review article, we aim to provide an overview on epidemiologic, clinic and laboratory aspects of both acquired and inherited rare thrombophilic risk factors, especially including dysfibrinogenemia, heparin cofactor II, thrombomodulin, lipoprotein(a), sticky platelet syndrome, plasminogen activator inhibitor-1 apolipoprotein E, tissue factor pathway inhibitor, paroxysmal nocturnal haemoglobinuria and heparin-induced thrombocytopenia.
血栓形成倾向,无论是获得性还是遗传性的,都可定义为易于发生血栓栓塞并发症的一种倾向。自1965年发现抗凝血酶缺乏以来,迄今已描述了许多其他情况,这些情况使得目前在大约60%-70%的血栓栓塞性疾病患者中能够检测到遗传性或获得性倾向。这些促血栓形成危险因素主要包括内源性凝血因子抑制剂的定性或定量缺陷、凝血蛋白浓度或功能增加、纤维蛋白溶解系统缺陷、血小板功能受损以及高同型半胱氨酸血症。在这篇综述文章中,我们旨在概述获得性和遗传性罕见血栓形成倾向危险因素的流行病学、临床和实验室方面,尤其包括异常纤维蛋白原血症、肝素辅因子II、血栓调节蛋白、脂蛋白(a)、血小板黏附综合征、纤溶酶原激活物抑制剂-1、载脂蛋白E、组织因子途径抑制剂、阵发性夜间血红蛋白尿和肝素诱导的血小板减少症。