Ray S A, Rowley M R, Loh A, Talbot S A, Bevan D H, Taylor R S, Dormandy J A
Department of Vascular Surgery, St George's Hospital Medical School, London, UK.
Br J Surg. 1994 Jun;81(6):811-4. doi: 10.1002/bjs.1800810607.
Hypercoagulable states are found in up to 10 per cent of patients with a history of unexplained venous thrombosis. To investigate the prevalence in arterial thrombosis, thrombophilia screening was performed on 124 patients who had previously undergone lower-limb revascularization, 45 claudicants and 27 controls. Of the patients who had undergone revascularization 40 per cent had a hypercoagulation abnormality (low levels of protein C, protein S and antithrombin III or presence of the lupus anticoagulant) in comparison with 27 per cent of claudicants and 11 per cent of controls (P < 0.01). Furthermore, patients who had suffered reocclusion after revascularization were significantly more likely to have a hypercoagulation abnormality than those who had not (P < 0.05), even if the occlusion had occurred more than 6 months previously. Lupus anticoagulant was the abnormality most frequently detected and, like low protein C levels, was found only in patients with peripheral vascular disease. It appears that hypercoagulable states are common in patients with arterial disease and may predispose to failure of revascularization.
在有不明原因静脉血栓形成病史的患者中，高达10%的人存在高凝状态。为了调查动脉血栓形成的患病率，对124例先前接受过下肢血运重建术的患者、45例间歇性跛行患者和27例对照者进行了血栓形成倾向筛查。在接受血运重建术的患者中，40%存在高凝异常（蛋白C、蛋白S和抗凝血酶III水平低或存在狼疮抗凝物），而间歇性跛行患者为27%，对照者为11%（P<0.01）。此外，血运重建术后发生再闭塞的患者比未发生再闭塞的患者更有可能存在高凝异常（P<0.05），即使闭塞发生在6个月以前。狼疮抗凝物是最常检测到的异常，与低蛋白C水平一样，仅在周围血管疾病患者中发现。看来高凝状态在动脉疾病患者中很常见，可能易导致血运重建失败。
