Spiezia Luca, Forestan Chiara, Campello Elena, Simion Chiara, Simioni Paolo
General Medicine and Thrombotic and Haemorrhagic Diseases Unit, Department of Medicine, University of Padova, 35138 Padova, Italy.
J Clin Med. 2023 Jul 25;12(15):4890. doi: 10.3390/jcm12154890.
Coagulation factor XI (FXI) promotes fibrin formation and inhibits fibrinolysis. Elevated plasma FXI levels, limited to a single measurement, are associated with a higher thrombotic risk. Our case-control study aimed to identify the effect of persistently increased plasma FXI levels on the risk of deep vein thrombosis (DVT). All patients evaluated between January 2016 and January 2018 for a first episode of proximal DVT of the lower extremity were considered for enrolment. Plasma FXI levels were measured at least 1 month after the discontinuation of anticoagulant treatment (T1). The patients with increased plasma FXI levels (>90th percentile of controls) were tested again 3 months later (T2). Among the 200 enrolled patients (M/F 114/86, age range 26-87 years), 47 patients had increased plasma FXI levels at T1 and16 patients had persistently increased plasma FXI levels at T2. The adjusted odds ratio for DVT was 2.4 (95% CI, 1.3 to 5.5, < 0.001) for patients with increased FXI levels at T1 and 5.2 (95% CI, 2.3 to 13.2, < 0.001) for patients with persistently high FXI levels at T2. Elevated FXI levels constitute a risk factor for deep vein thrombosis, and this risk nearly doubled in patients with persistently increased plasma FXI levels. Larger prospective studies are needed to confirm our findings.
凝血因子XI（FXI）促进纤维蛋白形成并抑制纤维蛋白溶解。仅单次测量显示血浆FXI水平升高与较高的血栓形成风险相关。我们的病例对照研究旨在确定血浆FXI水平持续升高对深静脉血栓形成（DVT）风险的影响。2016年1月至2018年1月期间因下肢近端DVT首次发作接受评估的所有患者均被考虑纳入研究。在停用抗凝治疗至少1个月后（T1）测量血浆FXI水平。血浆FXI水平升高（>对照组第90百分位数）的患者在3个月后再次检测（T2）。在200名纳入研究的患者中（男/女114/86，年龄范围26 - 87岁），47名患者在T1时血浆FXI水平升高，16名患者在T2时血浆FXI水平持续升高。T1时FXI水平升高的患者发生DVT的校正比值比为2.4（95%CI，1.3至5.5，<0.001），T2时FXI水平持续升高的患者为5.2（95%CI，2.3至13.2，<0.001）。FXI水平升高是深静脉血栓形成的一个危险因素，血浆FXI水平持续升高的患者这一风险几乎加倍。需要更大规模的前瞻性研究来证实我们的发现。
