Blood:血栓易栓症和婴儿围产期中风的发生没有相关性

2017-05-23 MedSci MedSci原创

血栓易栓症和围产期的中风发生没有相关性,也因此对于婴儿进行易栓症检测对于防止围产期的中风没有必要。

围产期,是指怀孕28 周到产后一周这一分娩前后的重要时期。围产期婴儿的中风(perinatal stroke)会导致婴儿脑瘫和终身残疾。围产期中风的具体症状已经被定义的很明确,但是其发生机制的了解却为之甚少。有证据表明围产期动脉的中风与容易形成血栓的血栓易栓症(thrombophilia)之间可能存在关联,但基于一定的人群数量所进行的跟踪和对比研究是比较有限的。期待新生儿的降临原本是喜悦的,但是由于恐惧婴儿发生围产期中风,不少家长要求医生对于新生儿进行易栓症的检查。在众多指标中,但凡有个别指标为阳性,则对于家庭来说,就会因为不确定性而对于婴儿的未来忧心忡忡。

因此了解血栓易栓症(thrombophilia)是否对于围产期中中风的发生有一定的关联,对于研究围产期中风的发病机制和临床治疗有重要意义。

在最新的一期Blood杂志中,Colleen Curtis及其同事报道了一项他们进行的基于大规模群体的对于血栓易栓症是否与围产期中分相关的观察研究。根据核磁共振成像结果,研究人员招募了患有新生儿动脉缺血性中风(neonatal arterial ischemic stroke, NAIS),动脉推定围产期缺血性中风(arterial presumed perinatal ischemic stroke,APPIS)或胎儿脑室周围静脉梗死(fetal periventricular venous infarction)的儿童进行这一项研究。

在一岁后,对于中风组和对照组进行标准的血栓易栓症检测,包括测量C蛋白(protein C)和S蛋白 (protein S),抗凝血酶(anti-thrombin),因子VIII / IX / XI(Factors VIII/IX/XI),纤维蛋白原(fibrinogen),脂蛋白a(lipoprotein(a)),同型半胱氨酸(homocysteine),狼疮抗凝血剂(lupus anticoagulant),抗心磷脂抗体(anti-cardiolipin antibodies),和检测Factor V Leiden(FVL),Factor II G20210A(FII)和亚甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase)C677T这三个基因的基因分型。共有212名儿童被研究:包括46名患有NAIS,34名为APPIS,55名为PVI,77名为对照(男性为53%;年龄中位数为4.8岁)。在上述14个参数中,12例均未观察到明显差异。

这项研究指出,血栓易栓症和围产期的中风发生没有相关性,也因此对于婴儿进行易栓症检测对于防止围产期的中风没有必要。

原始出处:
Colleen Curtis et al. Thrombophilia risk is not increased in children after perinatal stroke. Blood 2017 129:2793-2800; doi: https://doi.org/10.1182/blood-2016-11-750893

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    2017-05-25 lou.minghong

    学习

    0

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    2017-05-25 ylzr123

    感谢小编为我们精心准备了如此精辟的精神大餐,小编辛苦了,点个赞吧!

    0

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    2017-05-23 榄枷檬

    围产期,是指怀孕28周到产后一周这一分娩前后的重要时期。围产期婴儿的中风(perinatalstroke)会导致婴儿脑瘫和终身残疾

    0

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    2017-05-23 1e16d8a5m40(暂无匿称)

    学习了

    0