Bayer D D, Sorbello A F, Condoluci D V
Division of Infectious Diseases, University of Medicine and Dentistry of New Jersey--School of Osteopathic Medicine, Stratford, USA.
J Am Osteopath Assoc. 1995 Apr;95(4):276-7.
Bilateral subclavian vein thrombi developed, in the presence of a Groshong catheter, in a patient with the acquired immunodeficiency syndrome (AIDS) and disseminated cytomegalovirus infection. Thrombosis is an uncommon complication of AIDS, and bilateral subclavian thrombi are rare. Although localized, unilateral thrombi occur in patients with indwelling central venous catheters, unexpectedly extensive bilateral clot formation is seen to develop in patients with human immunodeficiency virus infection. Potentially predisposing factors for thrombosis in AIDS include central venous catheterization, malignancy, elevated anticardiolipin antibodies, alteration of vascular endothelial cell function reflected in low free protein S levels, and enhanced endothelial procoagulant activity related to cytomegalovirus. Anecdotal data strongly suggest that cytomegalovirus enhances the risk for thrombosis, but studies are needed to confirm the association. Physicians should be aware of the enhanced risk for extensive thrombi in AIDS, especially in patients with disseminated cytomegalovirus infection.
在一名患有获得性免疫缺陷综合征（AIDS）并伴有播散性巨细胞病毒感染的患者中，在植入Groshong导管的情况下发生了双侧锁骨下静脉血栓形成。血栓形成是AIDS的一种罕见并发症，双侧锁骨下血栓则更为罕见。尽管留置中心静脉导管的患者会出现局限性的单侧血栓，但在人类免疫缺陷病毒感染患者中却意外地出现了广泛的双侧血栓形成。AIDS患者血栓形成的潜在易感因素包括中心静脉置管、恶性肿瘤、抗心磷脂抗体升高、游离蛋白S水平降低所反映的血管内皮细胞功能改变以及与巨细胞病毒相关的内皮促凝活性增强。轶事数据强烈表明巨细胞病毒会增加血栓形成的风险，但仍需研究来证实这种关联。医生应意识到AIDS患者发生广泛血栓的风险增加，尤其是在患有播散性巨细胞病毒感染的患者中。
