Lecouffe-Desprets M, Graveleau J, Artifoni M, Connault J, Agard C, Pottier P, Hamidou M, Néel A
Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
Rev Med Interne. 2019 Apr;40(4):232-237. doi: 10.1016/j.revmed.2018.10.387. Epub 2019 Feb 14.
Many factors can contribute to the risk of venous thrombosis observed in hemolytic diseases. Some mechanisms are related to hemolysis by itself, while others seem more specific to each disease. Despite recent advances in the quantification of this risk and in understanding its physiopathology, the association of hemolysis with venous thrombosis is often unknown. The purpose of this general review is to clarify the main pro-thrombotic mechanisms during hemolysis and to synthesize the clinical data currently available. We will focus on the main types of hemolytic pathologies encountered in current practice, namely paroxysmal nocturnal hemoglobinuria, hemoglobinopathies, auto-immune hemolytic anemia and thrombotic microangiopathies.
许多因素可导致溶血性疾病中出现静脉血栓形成风险。一些机制与溶血本身相关,而其他机制似乎对每种疾病更具特异性。尽管近期在该风险的量化及其病理生理学理解方面取得了进展,但溶血与静脉血栓形成之间的关联往往仍不明确。这篇综述的目的是阐明溶血过程中的主要促血栓形成机制,并综合目前可用的临床数据。我们将重点关注当前临床实践中遇到的主要溶血性疾病类型,即阵发性夜间血红蛋白尿、血红蛋白病、自身免疫性溶血性贫血和血栓性微血管病。