Association of Coagulation Activation with Clinical Complications in Sickle Cell Disease 英文参考文献.docVIP
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Association of Coagulation Activation with Clinical Complications in Sickle Cell Disease 英文参考文献
AssociationofCoagulationActivationwithClinical
ComplicationsinSickleCellDisease
KennethI.Ataga1*,JuliaE.Brittain2,PayalDesai1,RyanMay3,SusanJones1,JohnDelaney1¤ ,Dell
Strayhorn1,AlanHinderliter4,NigelS.Key1
1DivisionofHematology/Oncology,UniversityofNorthCarolina,ChapelHill,NorthCarolina,UnitedStatesofAmerica,2DepartmentofBiochemistryandBiophysics,
UniversityofNorthCarolina,ChapelHill,NorthCarolina,UnitedStatesofAmerica,3DepartmentofBiostatistics,UniversityofNorthCarolina,ChapelHill,NorthCarolina,
UnitedStatesofAmerica,4DivisionofCardiology,UniversityofNorthCarolina,ChapelHill,NorthCarolina,UnitedStatesofAmerica
Abstract
Background: The contribution of hypercoagulability to the pathophysiology of sickle cell disease (SCD) remains poorly
defined. We sought to evaluate the association of markers of coagulation and platelet activation with specific clinical
complicationsandlaboratoryvariablesinpatientswithSCD.
Design and Methods: Plasma markers of coagulation activation (D-dimer and TAT), platelet activation (soluble CD40
ligand),microparticle-associatedtissuefactor(MPTF)procoagulantactivityandotherlaboratoryvariableswereobtainedin
a cohort of patients with SCD. Tricuspid regurgitant jet velocity was determined by Doppler echocardiography and the
presence/historyofclinicalcomplicationswasascertainedatthetimeofevaluation,combinedwithadetailedreviewofthe
medicalrecords.
Results:NosignificantdifferencesinthelevelsofD-dimer,TAT,solubleCD40ligand,andMPTFprocoagulantactivitywere
observed between patients in the SS/SD/Sb0 thalassemia and SC/Sb+ thalassemia groups. Both TAT and D-dimer were
significantlycorrelatedwithmeasuresofhemolysis(lactatedehydrogenase,indirectbilirubinandhemoglobin)andsoluble
vascularcelladhesionmolecule-1.InpatientsintheSS/SD/Sb0thalassemiagroup,D-dimerwasassociatedwithahistoryof
stroke(p=0.049),TATwasassociatedwithahistoryofretinopathy(p=0.0176),andCD40ligandwasassociatedwiththe
frequency of pain episodes (p=0.039). In multivariate analyses, D-dimer wa
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