Cytomegalovirus infection is associated with venous thromboembolism of immunocompetent adults-a case-control study
Cytomegalovirus infection is associated with venous thromboembolism of immunocompetent adults-a case-control study
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DOI：
10.1007/s00277-011-1334-9
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发表时间：
2012-04-01
影响因子：
3.5
通讯作者：
Schambeck, Christian M.
中科院分区：
文献类型：
--
作者：
Schimanski, Sven;Linnemann, Birgit;Schambeck, Christian M.
巨细胞病毒（CMV）似乎有助于免疫功能低下患者静脉血栓栓塞（VTE）的发展，而关于免疫功能正常个体中作用的文献数据主要限于病例报告。本研究旨在研究巨细胞病毒感染是否有助于免疫功能正常个体发生静脉血栓栓塞。对166例VTE患者和166例性别、年龄相匹配的健康献血员的标本进行CMV-IgG、CMV-IgM抗体滴度、CMV-IgG亲合力和CMV-DNA鉴定。与对照组相比，在VTE患者中发现CMV-IgG抗体的频率更高[57. 8% vs. 44. 0%;校正OR 1. 75（95% CI 1. 13 - 2. 70）; p = 0. 016]。因此，病例组中CMV-IgG滴度中位数显著较高（89.4 vs. 1.8 Au/ml; p = 0.002）。虽然总体发病率较低，但CMV-IgM抗体在病例中的检出率高于对照组。在发生无端VTE事件的患者中差异显著[7.4% vs. 0.6%;校正OR 5.26（95% CI 1.35-20.8）; p = 0.017]。几乎所有的VTE患者（98.9%）和对照组（98.6%）的CMV-IgG抗体均为高亲和力。CMV-DNA阳性率较低，病例组与对照组无差异。除年龄外，在VTE组中未发现CMV血清阳性与已确定的VTE危险因素之间存在关联。巨细胞病毒感染似乎在免疫功能正常的患者发生静脉血栓栓塞中起作用。复发感染可能比急性CMV感染更重要。
Cytomegalovirus (CMV) seems to contribute to the development of venous thromboembolism (VTE) in immunocompromised patients whereas literature data on the role in immunocompetent individuals are mainly limited to case reports. This study aimed to investigate if cytomegalovirus infection contributes to the development of VTE in immunocompetent individuals. CMV-IgG and CMV-IgM antibody titres, CMV-IgG avidity and CMV-DNA were identified in samples from 166 VTE patients and from 166 healthy blood donors matched for gender and age. CMV-IgG antibodies were found more frequently in VTE patients compared to controls [57.8% vs. 44.0%; adjusted OR 1.75 (95% CI 1.13-2.70); p = 0.016]. Accordingly, median CMV-IgG titres were significantly higher in the case group (89.4 vs. 1.8 AU/ml; p = 0.002). Although the overall rate was low, CMV-IgM antibodies were detected more often among cases than controls. The difference was significant in patients with an unprovoked VTE event [7.4% vs. 0.6%; adjusted OR 5.26 (95% CI 1.35-20.8); p = 0.017]. CMV-IgG antibodies of almost all VTE patients (98.9%) and controls (98.6%) were found to be of high avidity. The rate of positive CMV-DNA samples was low and not different between cases and controls. With the exception of age, no association was found between CMV seropositivity and established VTE risk factors within the VTE group. CMV infection seems to play a role in the development of VTE in immunocompetent patients. Recurrent infection might be more important than acute CMV infection.