Thromboembolism and resistance to activated protein C in patients with inflammatory bowel disease

作     者：Novacek, G Miehsler, W Kapiotis, S Katzenschlager, R Speiser, W Vogelsang, H 

作者机构：Univ Vienna Dept Internal Med 4 Div Gastroenterol & Hepatol A-1090 Vienna Austria Univ Vienna Clin Inst Med & Chem Lab Diagnost A-1090 Vienna Austria Univ Vienna Dept Internal Med 2 Div Angiol A-1090 Vienna Austria 

出 版 物：《AMERICAN JOURNAL OF GASTROENTEROLOGY》 (美国胃肠病学杂志)

年 卷 期：1999年第94卷第3期

页      面：685-690页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：活化蛋白C抵抗/并发症 抗凝血酶Ⅲ/分析 C反应蛋白质/分析 纤维蛋白原/分析 炎性肠疾病/血液 炎性肠疾病/并发症 危险因素 血栓栓塞/血液 血栓栓塞/病因学 青少年 成年人 老年人 女(雌)性 人类 男(雄)性 中年人 

摘      要：OBJECTIVE: Thromboembolic events are serious complications in patients with inflammatory bowel disease (IBD). Resistance of factor V to degradation by activated protein C (APC) is a major cause for venous thrombosis and is found in approximately 30% of patients with thromboembolism. The aim of the present study was to assess the prevalence of APC resistance and clinical risk factors in patients with IBD. METHODS: One-hundred-two patients with IBD (64 women and 38 men;median age, 35 yr;range, 17-77 yr;77 with Crohn s disease, 25 with ulcerative colitis) and 102 gender- and age-matched healthy control subjects were investigated prospectively for the presence of APC resistance. None of the healthy controls but 16 patients with IBD had a history of thromboembolism. RESULTS: Patients with IBD and thromboembolism were young, with a median age of 37 yr (range, 17-61 yr). Five (31.3%) of them had APC resistance, which was more common than in patients with IBD without thromboembolism (7%) and in controls (5.9%) (p 0.01). Three patients had two thromboembolic events, the other 13 each had one. Deep vein thrombosis of the leg and pulmonary emboli were the most common thromboembolic complications (84.2%). Active disease, fistula, or bowel stenosis were found in 10 (52.6%) of 19 thromboembolic events;in three (15.8%) cases thromboembolism happened postoperatively. CONCLUSIONS: APC resistance is not associated with IBD but, when present, increases the risk of thromboembolism. Patients with IBD and thromboembolism are mostly young and clinical risk factors can be found in one-half of cases. (Am J Gastroenterol 1999;94:685-690. (C) 1999 by Am. Cell. of Gastroenterology).