Shimazu C, Koizumi H, Nishida J, Kazama M, Miyazawa Y
Central Laboratory, Teikyo University Hospital, Tokyo.
Rinsho Byori. 1997 Apr;45(4):328-33.
We examined the incidence of thrombophilia in deep vein thrombosis (DVT). Of 38 cases, we found 4 cases of protein C abnormality, 2 cases each of protein S abnormality and lupus anticoagulant, 1 case of antithrombin III abnormality. The total incidence was 23.7%, whereas only 2 cases (6.2%) of plasminogen abnormality were found among 32 healthy individuals. The incidence of thrombophilia was apparently higher among patients with DVT than that of healthy subjects, although the incidence of Japanese DVT was lower than that of Caucasian DVT, as previously reported. By SSCP analysis in one case of protein C abnormality, we demonstrated an abnormality of exon 9-3. To establish laboratory diagnosis of thrombophilia, it is recommended that (1) severe liver diseases, DIC, and oral anticoagulant be ruled out, (2) abnormality be confirmed by repeated examination, (3) family study determine inheritance mode, if possible. It was strongly suggested that laboratory examination of thrombophilia should be routinely applied to cases of venous thrombosis including DVT, not only for diagnostic interest but also for appropriate treatment of these cases.
我们研究了深静脉血栓形成(DVT)中血栓形成倾向的发生率。在38例患者中,我们发现4例蛋白C异常,2例蛋白S异常和狼疮抗凝物,1例抗凝血酶III异常。总发生率为23.7%,而在32名健康个体中仅发现2例(6.2%)纤溶酶原异常。尽管如先前报道,日本DVT的发生率低于白种人DVT,但DVT患者中血栓形成倾向的发生率明显高于健康受试者。通过对1例蛋白C异常病例进行单链构象多态性(SSCP)分析,我们证实了外显子9 - 3存在异常。为了建立血栓形成倾向的实验室诊断,建议:(1)排除严重肝病、弥散性血管内凝血(DIC)和口服抗凝剂;(2)通过重复检查确认异常;(3)如有可能,进行家族研究以确定遗传模式。强烈建议对包括DVT在内的静脉血栓形成病例常规进行血栓形成倾向的实验室检查,这不仅出于诊断目的,也为了对这些病例进行适当治疗。