M. Bokarewa, G. Falk, M. Sten-Linder, N. Egberg, M. Blombäck, K. Bremme
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引用次数: 20
摘要
81名有血栓形成史的女性被分为三组:第一组(n = 29),在口服避孕药期间出现血栓形成的女性;II组(n = 33),使用口服避孕药(OC)无并发症,但在其他危险情况下发生血管闭塞的患者;III组(n = 19),从未使用过OC的女性。研究了阴离子磷脂(PLa)抗体水平、活化蛋白C (APC)抗体水平以及引起APC耐药的凝血因子V基因突变的存在。在研究组中,14% - 42%的患者存在APC耐药。约半数apc耐药患者PLa升高。APC耐药发生率与组内血栓事件的复发率相关。在大多数情况下,它与因子V基因的突变密切相关。在服用OC期间发生血栓形成的女性(I组)与其他组不同,APC耐药最低发生率与突变数量相对增加之间存在显著差异(14% vs 38%, p < 0.025)。这一发现表明APC反应是灵活的。讨论了OC对APC反应降低的影响。
Eighty-one women with a history of thrombosis were classified into three groups: group I (n = 29), women in whom thrombosis developed during oral contraception; group II (n = 33), those who used oral contraceptives (OC) without complications but experienced vascular occlusion in other risk situations; group III (n = 19), women who never used OC. The level of antibodies to anionic phospholipids (PLa), a response to activated protein C (APC), and the presence for the mutation in the coagulation factor V gene causing APC resistance were studied. In the studied groups, APC resistance was present in 14% to 42% of patients. PLa were elevated in about half of APC-resistant patients. The incidence of APC resistance correlated with the recurrency of the thrombotic events within the groups. In most cases it was tightly connected to the mutation in the factor V gene. Women in whom thrombosis developed while they were taking OC (group I) differed from the others, having a remarkable disagreement between the lowest incidence of APC resistance and a relatively increased number of the mutation (14% vs 38%, p < 0.025). This finding suggested that the APC response is flexible. An influence of OC that predisposes a reduction in APC response is discussed.