血栓性素因（PT、APTT、Dダイマー）の異なる血栓症タイプにおける差次的解析

Thrombotic disorders, including venous thrombosis, arterial thrombosis, and disseminated intravascular coagulation (DIC), are major contributors to global morbidity and mortality. Venous thromboembolism event occurs in 1 to 2 per 1000 individuals annually, while DIC carries a mortality rate exceeding 20%. Coagulation indices such as prothrombin time (PT), activated partial thromboplastin time (APTT), and d-dimer are widely used for diagnosis, risk assessment, and treatment planning, but comparative studies across different thrombus types remain limited. In this single-center retrospective study, 220 patients with thrombophilia (100 venous thrombosis, 80 arterial thrombosis, and 40 DIC) admitted between January 2023 and December 2024 were analyzed. Clinical and laboratory data were collected to evaluate differences in PT, APTT, and d-dimer. Subgroup analyses compared deep vein thrombosis with pulmonary embolism and cerebral infarction with myocardial infarction. Multivariate logistic regression was performed to assess independent risk factors for arterial thrombosis. Significant intergroup differences were observed in PT, APTT, and d-dimer (all P < .001), with the most pronounced abnormalities in DIC. Subgroup analysis showed more severe coagulation abnormalities in pulmonary embolism compared with deep vein thrombosis, and higher d-dimer levels in myocardial infarction than in cerebral infarction. Logistic regression identified PT (odds ratio = 1.521, 95% confidence interval: 1.190-1.944, P = .001) and d-dimer (odds ratio = 6.294, 95% confidence interval: 3.293-12.030, P < .001) as independent risk factors for arterial thrombosis, whereas APTT, age, and sex were not significant. These findings demonstrate distinct coagulation profiles among thrombus types and support the utility of PT and d-dimer in differential diagnosis, risk stratification, and individualized management of thrombophilia.