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回顾性分析因子 VII 缺乏症患者的临床和实验室数据:单中心经验。

A Retrospective Analysis of Clinical and Laboratory Data of Patients with Factor VII Deficiency: A Single Centre Experience.

机构信息

Department of Medicine, Jagiellonian University Medical College, Krakow, Poland.

Department of Haematology, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Hamostaseologie. 2019 Nov;39(4):368-376. doi: 10.1055/s-0039-1693425. Epub 2019 Jul 30.

Abstract

Bleeding phenotype in patients with congenital factor VII (FVII) deficiency is highly variable. No direct correlation between FVII activity and bleeding tendency is noted. The aim of this study was to analyse clinical and laboratory phenotype of patients with FVII deficiency treated in one haemophilia treatment centre in Little Poland. Clinical and laboratory data of 106 patients were collected retrospectively. Bleeding symptoms were evaluated according to the Bleeding Assessment Tool. The mean FVII activity was 19.5% (range: 1.0-49.2) and the mean prothrombin time (PT) was 29.7 seconds (range: 13.2-64.8), comparable in both sexes. Activity was lower than 1% in 6.6% of individuals. The average age at diagnosis (31.2 years; range: 1-76) did not correlate with FVII activity. Half of the patients were diagnosed incidentally, mostly due to routine PT measurement. The most frequently reported symptoms were gum, nose and tooth extraction bleeds. A total of 22.6% of patients remained asymptomatic and 60.4% never required replacement therapy. Thrombotic episodes were diagnosed in five women (4.7%). In conclusion, the clinical picture of the analysed group is similar to the previously described. It should be stressed that a significant risk of bleeds, including joint haemorrhages, can be expected in patients with mildest FVII deficiency (>26%) as well. The rate of thrombosis (4.7%) was similar to other reports, with all affected patients having strong prothrombotic risk factors or being intensively treated with FVII concentrate.

摘要

患有先天性因子 VII(FVII)缺乏症的患者的出血表型差异很大。FVII 活性与出血倾向之间没有直接相关性。本研究的目的是分析在小波兰的一个血友病治疗中心接受治疗的 FVII 缺乏症患者的临床和实验室表型。回顾性收集了 106 名患者的临床和实验室数据。根据出血评估工具评估出血症状。FVII 活性的平均值为 19.5%(范围:1.0-49.2),凝血酶原时间(PT)的平均值为 29.7 秒(范围:13.2-64.8),在男女之间无差异。有 6.6%的个体的活性低于 1%。诊断时的平均年龄(31.2 岁;范围:1-76)与 FVII 活性无关。一半的患者是偶然诊断出来的,主要是由于常规 PT 测量。报告最多的症状是牙龈、鼻子和牙齿出血。共有 22.6%的患者无症状,60.4%的患者从未需要替代治疗。5 名女性(4.7%)被诊断为血栓形成。总之,分析组的临床表现与先前描述的相似。应该强调的是,即使是最轻微的 FVII 缺乏症(>26%)的患者,也可能存在严重的出血风险,包括关节出血。(4.7%)的血栓形成率与其他报告相似,所有受影响的患者都有强烈的血栓形成危险因素或正在接受 FVII 浓缩物的强化治疗。

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