ackground : The formation of deep vein thrombosis reflects a balance between the effects
of thrombogenic stimuli and a series of protective mechanisms. Substantial progress has
been made in the last several decades in identifying hereditary and acquired risk factors
predisposing to deep vein trombosis. Even so, a large number of patients still have no
identifiable underlying cause for recurrent venous thrombosis. Elucidation of specific
predisposing factor (s) is required for proper management of thrombosis. For the Korean
patients, these factors have not been well characterized.
Methods : We analyzed clinical profiles of the patients with venous thromboembolsim and
investigated the laboratory abnormalities known to be associated with increased risk of
thrombosis.
Results :
1) The male-female ratio was 1:1.13 and age distribution showed 24.7% in fifth decade,
22.4% in sixth, 18.8% in fourth, 11.7% in third, 10.6% in seventh, 7.1% over 70 years old, and
4.7% under 20 years.
2) The thromboses were most commonly located in lower extremities (74.1%), and
intraabdominal thromboses were 16 cases (18.8%), thromboses of upper extremities 4 cases
(4.7%), superior vena cave thrombosis 1 case (1.2%) and pulmonary embolism without
evidence of deep vein thrombosis 1 case (1.2%). Thirtyfour percent of the cases were
diagnosed as having pulmonary embolism.
3) The clinical risk factors for venous thromboembolism were old age (17.0%), malignancy
(15.3%), prior history of venous thromboembolism (12.9%), postoperative state (10.6%),
immobilization (8.2%), hyperlipidemia (5.9%), systemic lupus erythematosus (4.7%), obesity
(4.7%), stasis (4.7%), nephrotic syndrome (3.5%), diabetes mellitus (3.5%), Behcet's disease
(2.4%), estrogen (2.4%). Twenty-nine percent of the cases had no indentifiable clinical risk
factors.
4) The laboratory abnormalities associated with venous thromboembolism were increase of
anticardiolipin antibody (19.4%), decrese of protein C activity (16.7%), decrease of protein S
(free form) antigenicity (10.7%), decrease of antithrombin III activity (5.9%), decrease of
tissue-type plasminogen activator (t-PA) (22.7%), increase of plasminogen activator inhibitor
type 1 (PAI-1) (29.4%) and decrease of fibrinolytic activity (42.4%)
Conclusion : Clinical and laboratory risk factors have been determined in 85 patients with
deep vein thrombosis and/ or pulmonary embolism in Korea. Major clinical risk factors for
venous thromboembolism included old age, malignancy, prior history, postoperative state and
immobilization. Among the laboratory abnormalities associated with venous thrombembolism,
increase of PAI-1 and/of decrease of t-PA, and increase of anticardiopipin antibody were
most frequently observed.
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