Department of Anaesthesiology, Riga East Clinical University Hospital, LV-1024 Riga, Latvia.
Centre of Plastic and Reconstructive Microsurgery of Latvia, LV-1024 Riga, Latvia.
Medicina (Kaunas). 2019 Sep 3;55(9):563. doi: 10.3390/medicina55090563.
: Thrombosis due to inherited hypercoagulability is an issue that has been raised in microvascular flap surgery previously. We analyzed the association of a single nucleotide polymorphism (SNP) in rs2066865 in the () gene, alteration in plasma fibrinogen concentration, and presence of microvascular flap thrombosis. : A total of 104 adult patients with microvascular flap surgery were subjected to an analysis of the presence of SNP rs2066865 in the gene. Alterations in plasma fibrinogen concentration according to genotype were determined as a primary outcome, and flap thrombosis was defined as a secondary outcome. : Flap thrombosis was detected in 11.5% of patients ( = 12). Successful revision of anastomosis was performed in four patients, resulting in a microvascular flap survival rate of 92.3%. We observed an increase in plasma fibrinogen concentration in genotype G/A and A/A carriers (G/G, 3.9 (IQR 4.76-3.04); G/A, 4.28 (IQR 5.38-3.18); A/A, 6.87 (IQR 8.25-5.49) (A/A vs. G/A, = 0.003 and A/A vs. G/G, = 0.001). Within group differences in microvascular flap thrombosis incidence rates were observed-G/G 6/79 (7.59%); G/A 5/22 (22.7%); A/A 1/3 (33.3%) (OR 0.30 95%; CI 0.044 to 0.57), = 0.016; RR 3.2-when G/G versus G/A and A/A were analyzed respectively. : A/A and G/A genotype carriers of a single nucleotide polymorphism in rs2066865 in the gene had a higher plasma fibrinogen concentration, and this might be associated with an increased microvascular flap thrombosis incidence rate. Determined polymorphism could be considered as a genetic marker associated with microvascular flap thrombosis development. To confirm the results of this study, the data should be replicated in a greater sample size.
遗传性高凝状态导致的血栓形成是先前微血管皮瓣手术中提出的一个问题。我们分析了单个核苷酸多态性（SNP）在 rs2066865 中的位置（）基因、血浆纤维蛋白原浓度的改变以及微血管皮瓣血栓形成的存在。总共对 104 例接受微血管皮瓣手术的成年患者进行了 rs2066865 基因的 SNP 分析。根据基因型确定血浆纤维蛋白原浓度的改变作为主要结果，皮瓣血栓形成定义为次要结果。11.5%的患者（=12）检测到皮瓣血栓形成。在 4 例患者中成功进行了吻合口修正，微血管皮瓣存活率为 92.3%。我们观察到基因型 G/A 和 A/A 携带者的血浆纤维蛋白原浓度升高（G/G，3.9（IQR 4.76-3.04）；G/A，4.28（IQR 5.38-3.18）；A/A，6.87（IQR 8.25-5.49）（A/A 与 G/A，=0.003，A/A 与 G/G，=0.001）。观察到微血管皮瓣血栓形成发生率的组内差异-G/G 79 例中有 6 例（7.59%）；G/A 22 例中有 5 例（22.7%）；A/A 3 例中有 1 例（33.3%）（OR 0.30 95%；CI 0.044 至 0.57），=0.016；RR 3.2-当分别分析 G/G 与 G/A 和 A/A 时。rs2066865 中单个核苷酸多态性的 A/A 和 G/A 基因型携带者的血浆纤维蛋白原浓度较高，这可能与微血管皮瓣血栓形成发生率增加有关。确定的多态性可以被认为是与微血管皮瓣血栓形成发展相关的遗传标志物。为了证实本研究的结果，应该在更大的样本量中复制这些数据。
