Association of Thrombophilia and Inflammation with Post-Thrombotic Syndrome

深静脉血栓形成（DVT）或肺栓塞每年影响1-3/1000的成年人群，或 每年近20万人，发病率随着年龄的增长呈指数级上升。静脉的负担 血栓形成主要涉及DVT，在20- 30岁的患者中，DVT并发血栓后综合征（PTS）。 50%的案件。PTS具有从轻度水肿到伴有营养性皮肤的致残性症状性疾病的范围 变化、慢性疼痛和静脉皮肤溃疡。虽然PTS被认为是由于 静脉瓣导致回流或慢性静脉阻塞限制流出，其他病因 PTS的决定因素尚未得到广泛研究。我们提出了一项基于人群的研究，以评估 多种族普通人群中慢性外周静脉疾病（CPVD）的分子决定因素 圣地亚哥人口研究（SDPS）参与者进行了详细的体格检查和双重检查， 根据解剖学和临床发现进行腿部超声检查，以确定是否存在CPVD。我们将解决 以下假设：1.在那些与高凝状态相关的遗传性疾病中， （“遗传性血栓形成倾向”）将增加深功能性静脉疾病（DFD）的风险 通过双功超声评估和浅表静脉功能性疾病（SFD），当它发生在 缺乏DFD和PTS的临床特征。2. DFD或SFD的风险会增加 具有PTS特征的受试者中，生物标志物水平较高的受试者反映了不同方面 炎症3.考虑到肥胖与CPVD和PTS风险的相关性， 具有PTS特征的DFD或SFD风险与反映脂肪细胞的生物标志物水平较高相关 产品.为了检验这些假设，将在储存的细胞中测量表型和遗传分子生物标志物。 SDPS参与者的生物标本，包括370例对照参与者和370例CPVD病例， 关注血栓后综合征。研究结果将允许形成关于病因的假设 临床诊断或临床无症状DVT后发生PTS的因素。PTS和CPVD影响 - 美国有250万人; 20%的人患有静脉溃疡的严重疾病。造成的残疾 估计每年损失200万个工作日，医疗费用为3亿美元。这里的发现可以形成 开发治疗和预防PTS的新疗法的基础。

Deep vein thrombosis (DVT) or pulmonary embolus affect 1-3 per 1000 yearly of the adult population, or nearly 200,000 per year, with an incidence that rises exponentially with age. The burden of venous thrombosis predominantly involves DVT, which is complicated by post-thrombotic syndrome (PTS) in 20- 50% of cases. PTS has a spectrum from mild edema to disabling symptomatic disease with trophic skin changes, chronic pain, and venous skin ulceration. While PTS is thought to occur as a result of damage to the venous valves with resultant reflux or chronic venous obstruction limiting outflow, additional etiologic determinants of PTS have not been extensively studied. We propose a population-based study to evaluate the molecular determinants of chronic peripheral venous disease (CPVD) in a multi-ethnic general population sample, the San Diego Population Study (SDPS). Participants had detailed physical examination and duplex leg ultrasound to establish presence of CPVD based on anatomic and clinical findings. We will address the following hypotheses: 1.Among those with hereditary disorders associated with the hypercoagulable state ("hereditary thrombophilia") there will be an increased risk of deep functional venous disease (DFD) assessed by duplex ultrasound and of superficial venous functional disease (SFD) when it occurs in the absence of DFD and together with clinical features of PTS. 2. There will be an increased risk of DFD or SFD with features of PTS, among participants with higher levels of biomarkers reflecting different aspects inflammation. 3. Given the association of obesity with the risk of CPVD and PTS, there will be an increased risk of DFD or SFD with features of PTS in association with higher levels of biomarkers reflecting adipocyte products. To test these hypotheses phenotypic and genetic molecular biomarkers will be measured in stored biological specimens of the SDPS participants including 370 control participants and 370 cases of CPVD, focusing on post-thrombotic syndrome. Findings will allow hypotheses to be formed concerning etiologic factors in the development of PTS after clinically diagnosed or clinically silent DVT. PTS and CPVD affect -2.5 million people in the United States; 20% develop severe disease with venous ulcers. Resultant disability is estimated at 2 million lost workdays/year and medical costs as $300 million yearly. Findings here can form the basis for development of new therapies to treat, and moreover prevent,PTS.