Froom P, Margulis T, Grenadier E, Palant A, David M, Aghai E
Institute of Hematology, Lady Davis Carmel Hospital, Haifa, Israel.
Thromb Haemost. 1988 Oct 31;60(2):230-1.
The levels of von Willebrand factor (vWF:Ag) were measured in 27 patients with mitral valve prolapse (MVP) and compared to 27 age matched controls. Decreased levels of vWF:Ag (less than 80%) were found in 59% (16/27) of those with MVP compared to only 7% (2/27) of the controls (p less than 0.001). Mean vWF: Ag levels were also significantly lower in those with MVP (68 +/- 30% versus 100 +/- 23%, p less than 0.001). In those with MVP and congestive heart failure secondary to rupture chordae tendineae, however, the mean level of vWF: Ag was not significantly different from control values (95 +/- 32). There was an increased incidence of recurrent nose bleeds in those with MVP and low levels of vWF:Ag. We conclude that there is a relationship between MVP and low levels of vWF:Ag which may explain the increased incidence of epistaxis in such patients. Increased release of vWF:Ag in those with MVP and concomitant congestive heart failure may account for the normal levels found in this subgroup.
对27例二尖瓣脱垂（MVP）患者测定了血管性血友病因子（vWF:Ag）水平，并与27例年龄匹配的对照者进行比较。MVP患者中59%（16/27）的vWF:Ag水平降低（低于80%），而对照组仅7%（2/27）出现这种情况（p<0.001）。MVP患者的平均vWF:Ag水平也显著较低（68±30%对100±23%，p<0.001）。然而，在因腱索断裂继发充血性心力衰竭的MVP患者中，vWF:Ag的平均水平与对照值无显著差异（95±32）。vWF:Ag水平低的MVP患者鼻出血复发的发生率增加。我们得出结论，MVP与低水平的vWF:Ag之间存在关联，这可能解释了此类患者鼻出血发生率增加的原因。MVP合并充血性心力衰竭患者vWF:Ag释放增加可能是该亚组中vWF:Ag水平正常的原因。
