文章：

真性红细胞增多症中动脉血栓与静脉血栓的危险因素：587例单中心经验

Risk factors for arterial versus venous thrombosis in polycythemia vera: a single center experience in 587 patients

原文发布日期：2017-12-27

DOI: 10.1038/s41408-017-0035-6

类型: Article

开放获取: 是

英文摘要：

In a recent International Working Group on Myeloproliferative Neoplasms Research and Treatment (IWG-MRT) study, prior arterial events and hypertension were predictors of subsequent arterial thrombosis whereas prior venous events and age ≥65 years predicted venous thrombosis in polycythemia vera (PV). In the current study, we sought to validate the above findings and identify additional predictors of arterial versus venous thrombosis. At a median follow up of 109 months, thrombosis after diagnosis occurred in 128 (22%) patients; 82 (14%) arterial and 57 (10%) venous events. On multivariate analysis, prior arterial events (<0.0001), hyperlipidemia (p = 0.03), and hypertension (p = 0.02) predicted subsequent arterial events. In comparison, prior venous events (p = 0.05), leukocytosis ≥11 × 109/L (p = 0.002), and major hemorrhage (p = 0.02) were predictors of subsequent venous events. Salient associations with arterial thrombosis included age ≥ 60 years, hypertension, diabetes, hyperlipidemia and normal karyotype whereas age ≤ 60 years, females, palpable splenomegaly and history of major hemorrhage were associated with venous thrombosis. TET2 or ASXL1 mutations did not impact arterial nor venous thrombosis. In conclusion, we identify distinct associations for arterial versus venous thrombosis in PV and confirm that a prior arterial or venous thrombotic event is the most reliable predictor of subsequent events.

摘要翻译： 

最近一项由骨髓增殖性肿瘤研究与治疗国际工作组开展的研究表明，在真性红细胞增多症患者中，先前的动脉事件和高血压是后续动脉血栓形成的预测因素，而既往静脉事件和年龄≥65岁则预测静脉血栓形成。本研究旨在验证上述发现，并识别动脉与静脉血栓的其他预测因子。在中位随访109个月时，128例（22%）患者确诊后出现血栓形成，其中动脉事件82例（14%），静脉事件57例（10%）。多变量分析显示，既往动脉事件（p<0.0001）、高脂血症（p=0.03）和高血压（p=0.02）可预测后续动脉事件；而既往静脉事件（p=0.05）、白细胞计数≥11×10⁹/L（p=0.002）及大出血（p=0.02）是后续静脉事件的预测因子。与动脉血栓形成显著相关的因素包括年龄≥60岁、高血压、糖尿病、高脂血症及正常核型；而与静脉血栓形成相关的因素包括年龄≤60岁、女性、可触及脾肿大和大出血史。TET2或ASXL1突变对动脉或静脉血栓形成均无影响。本研究明确了真性红细胞增多症中动脉与静脉血栓形成的不同关联因素，并证实既往动静脉血栓事件是后续事件最可靠的预测指标。

原文链接：

Risk factors for arterial versus venous thrombosis in polycythemia vera: a single center experience in 587 patients