Moland L, Sandset P M
Hematologisk forskningslaboratorium Medisinsk klinikk Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1998 Sep 30;118(23):3590-5.
Activated protein C resistance is an inherited thrombophilia caused by a point mutation in the factor V gene (G to A transition in nucleotide 1691 in the factor V gene with replacement of arginine (R) 506 by glutamine (Q) in the factor V molecule). The mutation is commonly named factor V R506Q or factor V Leiden. The mutation results in a poor anticoagulant response to activated protein C. APC resistance is inherited autosomally, and approximately 5-10% of the Norwegian population are carriers of the mutation. It is present in 20-50% of all cases of venous thromboembolism. Among asymptomatic heterozygous family members of affected individuals there is a five to eight-fold increase in the risk of venous thromboembolism, whereas there may be a 100-fold increased risk among homozygous individuals. The risk for asymptomatic carriers without a family history is yet not known. Activated protein C resistance is a major risk factor for venous thromboembolism, and the detection of activated protein C resistance is vital for proper prophylaxis and treatment of this disorder. It is essential therefore that as many medical specialists as possible acquire knowledge of activated protein C resistance. This report describes a family with activated protein C resistance and the main indications for screening for inherited thrombophilia.
活化蛋白C抵抗是一种遗传性血栓形成倾向,由凝血因子V基因的点突变引起(凝血因子V基因第1691位核苷酸由G突变为A,导致凝血因子V分子中的精氨酸(R)506被谷氨酰胺(Q)取代)。该突变通常被称为凝血因子V R506Q或凝血因子V莱顿突变。该突变导致对活化蛋白C的抗凝反应不佳。APC抵抗以常染色体显性方式遗传,挪威约5%-10%的人口是该突变的携带者。在所有静脉血栓栓塞病例中,它的发生率为20%-50%。在受影响个体的无症状杂合子家庭成员中,静脉血栓栓塞的风险增加5至8倍,而在纯合子个体中,风险可能增加100倍。无家族史的无症状携带者的风险尚不清楚。活化蛋白C抵抗是静脉血栓栓塞的主要危险因素,检测活化蛋白C抵抗对于正确预防和治疗这种疾病至关重要。因此,尽可能多的医学专家了解活化蛋白C抵抗至关重要。本报告描述了一个患有活化蛋白C抵抗的家族以及遗传性血栓形成倾向筛查的主要指征。