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中华产科急救电子杂志 ›› 2023, Vol. 12 ›› Issue (02) : 71 -75. doi: 10.3877/cma.j.issn.2095-3259.2023.02.002

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易栓症与妊娠期血栓栓塞性疾病的关系、筛查及预防研究
黄启涛, 钟梅()   
  1. 广东省佛山市第一人民医院妇产科,佛山 528000
    南方医科大学南方医院妇产科,广州 510515
  • 收稿日期:2022-11-30 出版日期:2023-05-18
  • 通信作者: 钟梅

Research on the relationship, screening and prevention of thrombophilia and thromboembolic disease in pregnancy

Qitao Huang, Mei Zhong()   

  • Received:2022-11-30 Published:2023-05-18
  • Corresponding author: Mei Zhong
引用本文:

黄启涛, 钟梅. 易栓症与妊娠期血栓栓塞性疾病的关系、筛查及预防研究[J]. 中华产科急救电子杂志, 2023, 12(02): 71-75.

Qitao Huang, Mei Zhong. Research on the relationship, screening and prevention of thrombophilia and thromboembolic disease in pregnancy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2023, 12(02): 71-75.

易栓症是指存在各种遗传性或获得性因素而导致的血栓栓塞风险增加的病理状态。妊娠期特有的凝血潜能增加、抗凝血活性降低导致妊娠本身处于生理性高凝状态,当合并患有易栓症时,会增加发生妊娠期血栓栓塞性疾病的风险。目前对于易栓症与妊娠期并发症的相关性仍存在争议,本文主要论述易栓症与妊娠期血栓栓塞性疾病之间的关系以及筛查和预防策略。

Thrombophilia refers to a pathological condition with an increased risk of thromboembolism due to the presence of various inherited or acquired factors, an increased coagulation potential unique to pregnancy, and a reduced anticoagulant activity resulting in the pregnancy itself being physiologically hypercoagulable, which, when combined with thrombophilia, increases the risk of thromboembolic disease during pregnancy. There is still controversy about the association of thrombophilia with complications during pregnancy, and this article mainly addresses the association between thrombophilia and thromboembolic disease of pregnancy.

[1]
董艳玲,漆洪波. ACOG"妊娠期遗传性易栓症指南(2018)"解读[J]. 中国实用妇科与产科杂志201935(3):298-303.
[2]
中华医学会血液学分会血栓与止血学组. 易栓症诊断与防治中国指南(2021年版)[J]. 中华血液学杂志202142(11): 881-888.
[3]
Chiasakul TDe Jesus ETong J,et al. Inherited thrombophilia and the risk of arterial ischemic stroke: a systematic review and meta-analysis[J]. Journal of the American Heart Association20198(19):1-51.
[4]
Skeith L. Preventing venous thromboembolism during pregnancy and postpartum: crossing the threshold[J]. Hematology Am Soc Hematol Educ Program20172017(1):160-167.
[5]
徐琴,周容. 妊娠期及产褥期静脉血栓栓塞症的流行病学特征及发生机制[J]. 实用妇产科杂志202238(5):321-324.
[6]
Noguchi KNakazono ETsuda T,et al. Plasma phenotypes of protein S Lys196Glu and protein C Lys193del variants prevalent among young Japanese women[J]. Blood Coagulation & Fibrinolysis201930(8):393-400.
[7]
Padda JKhalid KMohan A,et al. Factor V Leiden G1691A and prothrombin gene G20210A mutations on pregnancy outcome[J]. Cureus202113(8):1-8.
[8]
Bezgin TKaymaz CAkbal Ö,et al. Thrombophilic gene mutations in relation to different manifestations of venous thromboembolism: a single tertiary center study[J]. Clinical and Applied Thrombosis/Hemostasis201824(1):100-106.
[9]
American College of Obstetricians and Gynecologists′ Committee on Practice Bulletins-Obstetries. ACOG Practice Bulletin No.197: inherited thrombophilias in pregnancy[J]. Obstet Gynecol2018132(1):e18-e34.
[10]
Croles FNNasserinejad KDuvekot JJ,et al. Pregnancy,thrombophilia,and the risk of a first venous thrombosis: systematic review and bayesian meta-analysis[J]. BMJ2017359:1-28.
[11]
Raia-Barjat TEdebiri OChauleur C. Venous thromboembolism risk score and pregnancy[J]. Frontiers in Cardiovascular Medicine20229:1-8.
[12]
Martinelli IDe Stefano V. Rare thromboses of cerebral,splanchnic and upper-extremity veins. a narrative review[J]. Thromb Haemost2010103(6):1136-1144.
[13]
Abbattista MCapecchi MMartinelli I. Treatment of unusual thrombotic manifestations[J]. Blood2020135(5):326-334.
[14]
Lauw MNBarco SCoutinho JM,et al. Cerebral venous thrombosis and thrombophilia: a systematic review and meta-analysis[J]. Seminars in Thrombosis and Hemostasis201339(8):913-927.
[15]
Kumar RVinny PWNair VG,et al. Comprehensive thrombophilia evaluation in cerebral venous thrombosis: a single center cross sectional study[J]. Indian Journal of Hematology and Blood Transfusion202238(3):522-528.
[16]
Martinelli IDe Stefano V. Rare thromboses of cerebral,splanchnic and upper-extremity veins. a narrative review[J]. Thromb Haemost2010103(6):1136-1144.
[17]
Lussana FDentali FAgeno W,et al. Venous thrombosis at unusual sites and the role of thrombophilia[J]. Seminars in Thrombosis and Hemostasis200733(6):582-587.
[18]
Iorio ABarnes CVedovati MC,et al. Thrombophilia and cerebral vein thrombosis[J]. Frontiers of neurology and neuroscience200823:55-76.
[19]
Dentali FGalli MGianni M,et al. Inherited thrombophilic abnormalities and risk of portal vein thrombosis[J]. Thrombosis and Haemostasis201799(4):675-682.
[20]
Subri IM, Yusof ZAM, Zainal NZ, et al. Role of porcine base anticoagulant during pregnancy and puerperium as prophylaxis treatment in venous thromboembolism (VTE): Shariah views and perspectives[J]. International journal of recent technology and engineering20198(2S11):567-574.
[21]
中华医学会围产医学分会.产科抗磷脂综合征诊断与处理专家共识[J]. 中华围产医学杂志202023(8):517-522.
[22]
Bundhun PKSoogund MZSHuang F. Arterial/venous thrombosis,fetal loss and stillbirth in pregnant women with systemic lupus erythematosus versus primary and secondary antiphospholipid syndrome: a systematic review and meta-analysis[J]. BMC Pregnancy and Childbirth201818(1):1-13.
[23]
Ruiz-Irastorza GCrowther MBranch W,et al. Antiphospholipid syndrome[J]. Lancet2010376(9751):1498-1509.
[24]
Glasnovic MBosnjak IVcev A,et al. Vascular thrombosis associated with antiphospholipide syndrome[J]. Coll Antropol200832(1):103-107.
[25]
Högdén AAntovic ABerg E,et al. Obstetric outcomes in patients with primary thrombotic and obstetric antiphospholipid syndrome and its relation to the antiphospholipid antibody profile[J]. Lupus201928(7): 868-877.
[26]
Saccone GBerghella VMaruotti GM,et al. Antiphospholipid antibody profile based obstetric outcomes of primary antiphospholipid syndrome: the PREGNANTS study[J]. Am J Obstet Gynecol2017216(5):521-525.
[27]
Tonello MCalligaro AFavaro M,et al. The first thrombotic event in purely obstetric antiphospholipid syndrome patients and in antiphospholipid antibody carriers: comparison of incidence and characteristics[J]. Archives of Gynecology and Obstetrics2021303(2):455-461.
[28]
Cervera RSerrano RPons-Estel GJ,et al. Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients[J]. Annals of the Rheumatic Diseases201574(6):1011-1018.
[29]
Jerez-Lienas AMathian AAboab J,et al. Cerebral vein thrombosis in the antiphospholipid syndrome: analysis of a series of 27 patients and review of the literature[J]. Brain Sciences202111(12):1-24.
[30]
Connors JM. Thrombophilia testing and venous thrombosis[J]. N Engl J Med2017377(12):1177-1187.
[31]
Shlomo MGorodischer RDaniel S,et al. The fetal safety of enoxaparin use during pregnancy: a population-based retrospective cohort study[J]. Drug Safety201740(11):1147-1155.
[32]
Jacobson BRambiritch VPaek D,et al. Safety and efficacy of enoxaparin in pregnancy: a systematic review and meta-analysis[J]. Advances in Therapy202037(1):27-40.
[33]
中华医学会妇产科学分会产科学组. 妊娠期及产褥期静脉血栓栓塞症预防和诊治专家共识[J]. 中华妇产科杂志202156(4):236-243.
[34]
刘真,孙瑜. 妊娠期及产褥期静脉血栓栓塞疾病诊治:2015英国皇家妇产科医师学会指南解读[J]. 中华围产医学杂志2017(12):841-845.
[35]
沈丽霞,王子莲. 妊娠期和产褥期静脉血栓栓塞的预防:2020年昆士兰临床指南解读[J]. 中国实用妇科与产科杂志202137(2):208-210.
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