The rate of progression to polycythemia vera or essential thrombocythemia in patients with erythrocytosis or thrombocytosis
The rate of progression to polycythemia vera or essential thrombocythemia in patients with erythrocytosis or thrombocytosis
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DOI：
10.7326/0003-4819-139-6-200309160-00009
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发表时间：
2003-09-16
影响因子：
39.2
通讯作者：
Rodeghiero, F
中科院分区：
文献类型：
--
作者：
Ruggeri, M;Tosetto, A;Rodeghiero, F
背景资料：轻度红细胞增多症的临床意义（女性红细胞压积> 0.48或男性> 0.51）或血小板增多症目的：评估普通人群中红细胞增多症或血小板增多症患者中真性红细胞增多症或原发性血小板增多症的频率。设计：队列研究。设置：Vicenza，意大利。参与者：10000名社区居民，年龄18至65岁，参加了维琴察血栓形成和动脉粥样硬化project.Measurements：血小板计数和红细胞压积在所有参与者的基线和第二次随访，如果基线结果异常。在确诊红细胞压积或血小板计数高的患者中，进行红细胞沉降率、外周动脉饱和度、血清促红细胞生成素水平和白细胞碱性磷酸酶水平的测量;胸部X线摄影;腹部超声检查;和潜血便试验。真性红细胞增多症和原发性血小板增多症的诊断根据红细胞增多症研究组criteria.Results：在基线检查，1人有真性红细胞增多症，1人有原发性血小板增多症，88人有红细胞增多症，99人有血小板增多症。在基线结果异常的患者中，第二次检查证实了40%（95% CI，29%-51%）的红细胞增多和8%（CI，4%-15%）的血小板增多。在确诊异常的患者中，进一步评价显示11例特发性红细胞增多症，2例真性红细胞增多症（3/ 10 000 [Cl，0.6 - 8.7/10 000]），3例原发性血小板增多症（4/10 000 [Cl，1.09 - 10.2/10 000]）。经过5年的随访，1个额外的人与高血小板计数发展为原发性血小板增多症，没有人出血或血栓形成的complications.Conclusions：真性红细胞增多症和原发性血小板增多症的患病率高于预期在这个一般人群。然而，红细胞增多症或血小板增多症患者发生真性红细胞增多症、原发性血小板增多症或相关血管并发症的风险较低。
Background: The clinical relevance of mild erythrocytosis (hematocrit > 0.48 in women or > 0.51 in men) or thrombocytosis (platelet count > 400 x 10(9) cells/L) in asymptomatic persons is uncertain.Objective: To estimate the frequency of polycythemia vera or essential thrombocythemia in persons with erythrocytosis or thrombocytosis in a general population.Design: Cohort study.Setting: Vicenza, Italy.Participants: 10000 community dwellers age 18 to 65 years and enrolled in the Vicenza Thrombophilia and Atherosclerosis project.Measurements: Platelet count and hematocrit at baseline in all participants and at second follow-up if baseline results were abnormal. Measurement of erythrocyte sedimentation rate, peripheral arterial saturation, serum erythropoietin level, and leukocyte alkaline phosphatase level; chest radiography; abdominal ultrasonography; and occult fecal blood testing were done in persons with confirmed high hematocrit or platelet counts. Polycythemia vera and essential thrombocythemia were diagnosed according to the Polycythemia Study Group criteria.Results: At baseline examination, 1 person had polycythemia vera, 1 had essential thrombocythemia, 88 had erythrocytosis, and 99 had thrombocytosis. Second examination confirmed erythrocytosis in 40% (95% Cl, 29% to 51%) and thrombocytosis in 8% (Cl, 4% to 15%) of those with abnormal baseline results. Among persons with confirmed abnormalities, further evaluation revealed 11 with idiopathic erythrocytosis, 2 with polycythemia vera (3/ 10 000 [Cl, 0.6 to 8.7/10 000]), and 3 with essential thrombocythemia (4/10 000 [Cl, 1.09 to 10.2/10 000]). After 5 years of follow-up, 1 additional person with a high platelet count developed essential thrombocythemia, and no persons developed hemorrhagic or thrombotic complications.Conclusions: The prevalences of polycythemia vera and essential thrombocythemia were higher than expected in this general population. However, the risks for developing polycythemia vera, essential thrombocythemia, or associated vascular complications in persons with erythrocytosis or thrombocytosis were low.