国际输血及血液学杂志
國際輸血及血液學雜誌
국제수혈급혈액학잡지
INTERNATIONAL JOURNAL OF BLOOD TRANSFUSION AND HEMATOLOGY
2013年
5期
385-388
,共4页
买买提力·依马木%王晓敏%李燕%安利
買買提力·依馬木%王曉敏%李燕%安利
매매제력·의마목%왕효민%리연%안리
血小板增多症,自发性%Janus激酶2%突变%血栓
血小闆增多癥,自髮性%Janus激酶2%突變%血栓
혈소판증다증,자발성%Janus격매2%돌변%혈전
thrombocythemia,essential%Janus Kinase 2%mutation%thrombosis
目的 探讨原发性血小板增多症(ET)患者血栓形成的相关因素,以及其在汉族与维吾尔族之间的差异.方法 选择2008年1月至2012年12月,于本院确诊的66例ET患者作为研究对象(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该伦理会批准,并与受试对象签订临床研究知情同意书).采用统一设计的调查表收集患者的性别、年龄、民族、外周血常规、骨髓形态学+活体组织检查、心电图、超声、头颅计算机断层扫描(CT)/磁共振(MR)、BCR/ABL融合基因、Ph-染色体、JAK2 V617F基因突变结果、既往血栓史及基础血管病史等信息,并随访54个月,观察患者血栓事件的发生情况,分析ET患者血栓形成的相关因素.结果 ①本组患者的JAK2 V617F突变发生率为71.2％(47/66).汉族ET患者突变阳性率高于维吾尔族患者(76.3％比64.3％),但差异无统计学意义(x2=1.138,P＞0.05).②随访54个月后,发现16例患者出现不同部位的血栓事件,发生率为24.2％,血管并发症及转归情况在汉族和维吾尔族患者之间的差异无统计学意义(x2=1.490,0.048;P＞0.05).③JAK2 V617F基因突变阳性、年龄≥60岁、白细胞(WBC)计数≥11×109/L、既往血栓史及合并有血管危险因素的ET患者易发生血栓栓塞事件(OR=4.292,95％CI:1.547～11.903；OR=6.800,95％CI:0.868～4.697；OR=4.460,95％CI:1.538～3.031;OR=4.364,95％CI:1.448～10.84;OR=3.494,1.509～8.092).结论 ET患者中有较高的JAK2 V617F基因突变率,该突变阳性、年龄≥60岁、WBC≥11×109/L、既往有血栓史及合并有血管危险因素的患者血栓发生风险较高,应尽早予以干预治疗.JAK2 V617F突变率、血管并发症及转归等情况在汉族和维吾尔族患者之间的差异不显著.
目的 探討原髮性血小闆增多癥(ET)患者血栓形成的相關因素,以及其在漢族與維吾爾族之間的差異.方法 選擇2008年1月至2012年12月,于本院確診的66例ET患者作為研究對象(本研究遵循的程序符閤本院人體試驗委員會所製定的倫理學標準,得到該倫理會批準,併與受試對象籤訂臨床研究知情同意書).採用統一設計的調查錶收集患者的性彆、年齡、民族、外週血常規、骨髓形態學+活體組織檢查、心電圖、超聲、頭顱計算機斷層掃描(CT)/磁共振(MR)、BCR/ABL融閤基因、Ph-染色體、JAK2 V617F基因突變結果、既往血栓史及基礎血管病史等信息,併隨訪54箇月,觀察患者血栓事件的髮生情況,分析ET患者血栓形成的相關因素.結果 ①本組患者的JAK2 V617F突變髮生率為71.2％(47/66).漢族ET患者突變暘性率高于維吾爾族患者(76.3％比64.3％),但差異無統計學意義(x2=1.138,P＞0.05).②隨訪54箇月後,髮現16例患者齣現不同部位的血栓事件,髮生率為24.2％,血管併髮癥及轉歸情況在漢族和維吾爾族患者之間的差異無統計學意義(x2=1.490,0.048;P＞0.05).③JAK2 V617F基因突變暘性、年齡≥60歲、白細胞(WBC)計數≥11×109/L、既往血栓史及閤併有血管危險因素的ET患者易髮生血栓栓塞事件(OR=4.292,95％CI:1.547～11.903；OR=6.800,95％CI:0.868～4.697；OR=4.460,95％CI:1.538～3.031;OR=4.364,95％CI:1.448～10.84;OR=3.494,1.509～8.092).結論 ET患者中有較高的JAK2 V617F基因突變率,該突變暘性、年齡≥60歲、WBC≥11×109/L、既往有血栓史及閤併有血管危險因素的患者血栓髮生風險較高,應儘早予以榦預治療.JAK2 V617F突變率、血管併髮癥及轉歸等情況在漢族和維吾爾族患者之間的差異不顯著.
목적 탐토원발성혈소판증다증(ET)환자혈전형성적상관인소,이급기재한족여유오이족지간적차이.방법 선택2008년1월지2012년12월,우본원학진적66례ET환자작위연구대상(본연구준순적정서부합본원인체시험위원회소제정적윤리학표준,득도해윤리회비준,병여수시대상첨정림상연구지정동의서).채용통일설계적조사표수집환자적성별、년령、민족、외주혈상규、골수형태학+활체조직검사、심전도、초성、두로계산궤단층소묘(CT)/자공진(MR)、BCR/ABL융합기인、Ph-염색체、JAK2 V617F기인돌변결과、기왕혈전사급기출혈관병사등신식,병수방54개월,관찰환자혈전사건적발생정황,분석ET환자혈전형성적상관인소.결과 ①본조환자적JAK2 V617F돌변발생솔위71.2％(47/66).한족ET환자돌변양성솔고우유오이족환자(76.3％비64.3％),단차이무통계학의의(x2=1.138,P＞0.05).②수방54개월후,발현16례환자출현불동부위적혈전사건,발생솔위24.2％,혈관병발증급전귀정황재한족화유오이족환자지간적차이무통계학의의(x2=1.490,0.048;P＞0.05).③JAK2 V617F기인돌변양성、년령≥60세、백세포(WBC)계수≥11×109/L、기왕혈전사급합병유혈관위험인소적ET환자역발생혈전전새사건(OR=4.292,95％CI:1.547～11.903；OR=6.800,95％CI:0.868～4.697；OR=4.460,95％CI:1.538～3.031;OR=4.364,95％CI:1.448～10.84;OR=3.494,1.509～8.092).결론 ET환자중유교고적JAK2 V617F기인돌변솔,해돌변양성、년령≥60세、WBC≥11×109/L、기왕유혈전사급합병유혈관위험인소적환자혈전발생풍험교고,응진조여이간예치료.JAK2 V617F돌변솔、혈관병발증급전귀등정황재한족화유오이족환자지간적차이불현저.
Objective To investigate the correlation between thrombosis and essential thrombocythemia(ET),and these differences between the Chinese Han and Uygur ethnic groups in Xinjiang.Methods From January 2008 to December 2012,a total of 66 patients who were diagnosed as ET in our hospital were included into this study.All of the patient's clinical data of gender,age,ethnicity,peripheral blood routine,bone marrow morphology and biopsy,electrocardiography,type-B ultrasonography,head computed tomography(CT)/magnetic resonance(MR),BCR/ABL fusion gene,Phchromosome,JAK2 V617F mutation,history of thrombosis and cardiovascular disease,and other information,were collected by unified design questionnaires and analyzed.Follow-up of 54 months,the patients' incidence of thromboembolic events were observed,and related factors between ET patients and thrombosis were analyzed.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the People's Hospital of Xinjiang Uygur Autonomous Region.Informed consent was obtained from all participants.Results(① JAK2 V617F mutation was detected in 47(71.2％)patients.The incidence of mutation in Chinese Han was higher than in Uyghur(76.3％ vs.64.3％),but the difference was not significant(x2=1.138,P＞0.05).(②)Followed for a median of 54 months[(3-148)months],16 patients developed thrombotic events.There were no significant in the two ethnic groups both of the vascular events and transformation(x2=1.490,0.048;P＞0.05).(③)Together with the high-risk condition such as age(≥60 years)and previous vascular events,white blood cell(WBC)value above 11×109/L and JAK2 V617F were significantly correlated with a higher thrombotic risk by logistic regression (OR=4.292,95％CI:1.547-11.903;OR=6.800,95％CI:0.868-4.697;OR=4.460,95％CI:1.538-3.031;OR=4.364,95％CI:1.448-10.84;OR=3.494,95％CI:1.509-8.092).Conclusions JAK2 V617F mutation occurs in significant percentage of patients with ET and patients with JAK2 V617F mutation are more susceptible to thrombosis.They were no significantly difference between Chinese Han and Uyghur minorities both of mutation rate,vascular events and transformation.Patients with JAK2 V617F+,age≥60 years,WBC≥11×109/L,previous vascular events and with cardiovascular risk factors were probably has higher rate of thromboembolism events,should given early intervention about antithrombotic treatment.
