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遗传血栓形成倾向标志物在老年 COVID-19 患者血栓事件中的作用。

Role of Genetic Thrombophilia Markers in Thrombosis Events in Elderly Patients with COVID-19.

机构信息

National Medical Research Center for Hematology, Novy Zykovski Lane 4a, 125167 Moscow, Russia.

Hospital Therapy Department No. 2, I.M. Sechenov First Moscow State Medical University, RF Health Ministry, Bolshaya Pirogovskaya St. 2, Bld. 4, 119435 Moscow, Russia.

出版信息

Genes (Basel). 2023 Mar 4;14(3):644. doi: 10.3390/genes14030644.

Abstract

Thrombosis is an extremely dangerous complication in elderly patients with COVID-19. Since the first months of the pandemic, anticoagulants have been mandatory in treatment protocols for patients with COVID-19, unless there are serious contraindications. We set out to discover if genetic thrombophilia factors continue to play a triggering role in the occurrence of thrombosis in patients with COVID-19 with prophylactic or therapeutic anticoagulants. We considered the following genetic markers as risk factors for thrombophilia: G1691A in the gene, C677T and A1298C in the gene, G20210A and C494T in the gene, and (-675) 4G/5G in the gene. In a cohort of 176 patients, we did not obtain a reliable result indicating a higher risk of thrombotic complications when taking therapeutic doses of anticoagulants in carriers of genetic markers for thrombophilia except the C494T mutation in the gene. However, there was still a pronounced tendency to a higher incidence of thrombosis in patients with markers of hereditary thrombophilia, such as G1691A and G20210A mutations. The presence of the C494T (Thr165Met) allele in the gene in this group of patients showed a statistically significant effect of the mutation on the risk of thrombotic complications despite anticoagulant therapy.

摘要

血栓形成是 COVID-19 老年患者极其危险的并发症。自大流行的最初几个月以来,除非有严重的禁忌症,否则抗凝剂一直是 COVID-19 患者治疗方案中的强制性治疗方法。我们着手研究预防性或治疗性抗凝剂是否会继续使遗传血栓形成因素在 COVID-19 患者血栓形成的发生中起触发作用。我们将以下遗传标记物视为血栓形成的危险因素:基因中的 G1691A、基因中的 C677T 和 A1298C、基因中的 G20210A 和 C494T 以及基因中的 (-675) 4G/5G。在 176 例患者队列中,我们没有获得可靠的结果,表明在携带血栓形成遗传标志物的患者中,使用治疗剂量的抗凝剂时,除了基因中的 C494T 突变外,血栓形成并发症的风险更高。然而,在具有遗传性血栓形成标志物的患者中,如 G1691A 和 G20210A 突变,血栓形成的发生率仍然存在明显的倾向。在这群患者中,基因中的 C494T(Thr165Met)等位基因的存在表明突变对血栓形成并发症的风险具有统计学意义,尽管进行了抗凝治疗。

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