Increased hemostasis potential persists in women with previous thromboembolism with or without APC resistance
Increased hemostasis potential persists in women with previous thromboembolism with or without APC resistance
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DOI：
10.1111/j.1538-7836.2003.00451.x
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发表时间：
2003-12-01
影响因子：
10.4
通讯作者：
He, S
中科院分区：
文献类型：
--
作者：
Antovic, A;Blombäck, M;He, S
背景资料：由于存在活化蛋白C（APC）抗性（伴或不伴因子（F）V Leiden突变）而导致的活化凝血酶生成和纤维蛋白溶解抑制与深静脉血栓形成（DVT）的发生相关。目的：使用我们最近开发的新的总体止血潜力（OHP）试验，更好地了解DVT复发风险背后的机制。患者和方法：OHP水平，以及APC耐药和FV莱顿突变，确定在88名妇女（病例）谁曾经历过DVT与怀孕，并在25个年轻的健康个体（对照）。还研究了凝血时间和凝块溶解时间。结果：与对照组相比，患者血清OHP水平升高。在APC耐药和Leiden突变的病例中，这种止血潜力的不平衡比那些没有的病例更严重。具有更严重失衡的组具有更短的凝血时间和更长的凝块溶解时间。结论：促凝血状态持续存在于有妊娠相关DVT病史的患者中，即使在症状期结束后。这种整体止血失衡背后的机制是凝血酶生成增强和纤维蛋白溶解抑制。这些发现可能强调需要血栓预防，以防止血栓栓塞复发的风险情况。
Background: Activated thrombin generation and depressed fibrinolysis due to the presence of activated protein C (APC) resistance with or without factor (F)V Leiden mutation are associated with development of deep venous thrombosis (DVT). Objective: A better understanding of the mechanism behind the risk of recurrence of DVT, using our new, recently developed assay of overall hemostasis potential (OHP). Patients and methods: Levels of OHP, as well as APC resistance and FV Leiden mutation, were determined in 88 women (cases) who had previously experienced DVT in connection with pregnancy, and in 25 young healthy individuals (controls). Clotting time and clot lysis time were also investigated. Results: OHP levels in the patients were increased compared with the controls. In the cases with APC resistance and the Leiden mutation this imbalance in hemostasis potential was more severe than in those without. The group with the more severe imbalance had shorter clotting times and longer clot lysis times. Conclusions: A procoagulant state perseveres in patients with a history of pregnancy-related DVT, even after the symptomatic phase is over. The mechanisms behind such an imbalance in overall hemostasis are enhanced thrombin generation and depressed fibrinolysis. These findings may underscore the need for thromboprophylaxis to prevent recurrence of thromboembolism in risk situations.