Thrombin generation profiles in deep venous thrombosis
Thrombin generation profiles in deep venous thrombosis
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DOI：
10.1111/j.1538-7836.2005.01584.x
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发表时间：
2005-11-01
影响因子：
10.4
通讯作者：
Rosendaal, FR
中科院分区：
文献类型：
--
作者：
Brummel-Ziedins, KE;Vossen, CY;Rosendaal, FR
背景L：可靠的指标和方法来预测血栓形成的风险是至关重要的临床管理。目的：使用一个综合的方法，定义一个人的综合凝血表型可能会证明在识别个人的风险经历血栓事件的价值。研究方法：使用数值模拟模型，我们使用莱顿血栓形成研究人群的凝血因子水平生成组织因子（TF）启动的凝血酶曲线，并根据性别、年龄、吸烟、饮酒、体重指数（BMI）和口服避孕药（OC）使用情况评估血栓形成风险。我们通过以下参数定量每个个体的综合TF-起始的凝血酶生成曲线的起始、增殖和终止阶段：至10 nM凝血酶的时间、最大时间、生成的凝血酶的水平和速率（MaxR）以及总凝血酶。结果：使用MaxR获得最大的风险关联;超过第90百分位数时，MaxR的风险增加2.6倍。MaxR的比值比（OR）在男性中为3.9，在女性中为2.1，在OC中为2.9。凝血酶生成的风险与年龄（OR：2.8 OR：2.5）BMI（OR：2.9：2.3）或饮酒无关。在数值模拟和经验合成血浆中，OC使用在对照组女性和血栓形成前的女性中产生了极端的凝血酶生成变化，在凝血酶生成不良对照组女性中具有较大的衬衫，这表明OC使用与潜在的血栓前异常的相互作用。结论：凝血酶的产生基于个体的血液成分与血栓形成的风险相关，并且可能是有用的LIS预测市场-用于评估个体基础上的血栓形成。
BackgroundL: Reliable markers and methods to predict risk for thrombosis are essential to clinical management. Objective: Using an integrated approach that defines an individual's comprehensive coagulation phenotype might prove valuables in identifying individuals at risk for experiencing a thrombotic event. Methods: Using a numerical simulation model, we generated tissue factor (TF) initiated thrombin curves using coagulation factor levels from the Leiden Thrombophilia Study population and evaluated thrombotic risk, by sex, age, smoking, alcohol consumption, body mass index (BMI) and oral contraceptive (OC) use. We quantitated the initiation, propagation and termination phases of each individuals comprehensive TF-initiated thrombin generation curve by the parameters: time to 10 nM of thrombin, maximum time, level and rate (MaxR) of thrombin generated and total thrombin. Results: The greatest risk association was obtained Using MaxR; with a 2.6-fold increased risk at MaxR exceeding the 90th percentile. The odds ratio (OR) for MaxR was 3.9 in men, 2.1 in women, and 2.9 in women on OCs. The association of risk with thrombin generation did not differ by age (OR:2.8 OR:2.5) BMI (OR:2.9 :2.3) Or alcohol Use. In both numerical simulations and empirical synthetic plasma, OC use created extreme shifts ill thrombin generation in both control women and women with it prior thrombosis, with a larger shirt in thrombin generation ill control women, This suggets in interaction of OC use with underlying prothrombotic abnormalities. Conclusions: Thrombin generation based Upon the individual's blood composition is associated with the risk for thrombosis and may be useful LIS a predictive market- for evaluating thrombosis on an individual basis.