偶然発見された小児の凝固異常の重要性
Gökçen Meral1, Ayça Koca Yozgat2, Vildan Çulha2
1Department of Pediatrics, Ankara City Hospital, Cankaya, Turkey.
まとめ
予期より軽度の凝固因子欠乏症は,偶発的にプロトロンビン時間 (PT) または活性化部分性血栓形成時間 (aPTT) が延長された子供においてより一般的です. これらの軽度な欠乏症は往々にして出血歴なしであり,その臨床的意義は不明である.
科学分野:
- 小児血液学
- ヘモスタシスと血栓形成
- 臨床凝固
背景:
- 詳細な anamnesis と身体検査は通常,ほとんどの出血障害を特定します.
- この研究では,偶発的にプロトロンビン時間 (PT) または活性化部分性血栓形成時間 (aPTT) が延長された小児患者の血静障害を調査した.
研究 の 目的:
- 偶発的なPT/aPTT延長を有する小児患者の血静性障害の発生率と種類を特定する.
- この集団における軽度の因子欠乏症の臨床的意義を評価する.
主な方法:
- 前例の血液疾患のない,偶発的な長時間のPTおよび/ またはaPTTを有する小児患者が登録されました.
- 凝固因子活動が分析された. アンチフォスフォリピド抗体とルプス抗凝固剤の検査は,異常な混合試験を有する患者に実施された.
主要な成果:
- 103人の患者のうち,50人が再検査時に持続的なPT/ aPTT異常を示した.
- コアグロパチは,コホート全体の30% (持続的な異常を有する患者の60%) で確認された.
- 最も頻繁な欠乏症は,因子XII (5. 8%),因子XI (4. 8%) および因子VII (2. 9%) であった.
結論:
- 軽度の凝固因子欠乏症は,偶発的なPT/aPTT延長を持つ子供では予想以上に一般的です.
- これらの軽度の欠乏症は,出血歴のない患者でも発生します.
- これらの軽度の因子欠乏症の臨床的意義と影響はしばしば不明である.
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