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Venous thrombosis and prothrombotic factors in inflammatory bowel disease

World Journal of Gastroenterology 2014年第17期20卷 4857-4872页

作者： Fernando Magro Jo?o-Bruno Soares Dália Fernandes Gastroenterology Department of Centro Hospitalar S?o Jo?o 4200-319 PortoPortugal Institute of Pharmacology and Therapeutics Faculty of MedicineUniversity of Porto4200-319 PortoPortugal IBMC Institute for Molecular and Cell BiologyUniversity of Porto4150-180 PortoPortugal Gastroenterology Department of Hospital de Braga 4710-243 BragaPortugal Gastroenterology Department of Centro Hospitalar da Cova da Beira 6200-251 Covilh?Portugal

Patients with inflammatory bowel disease(IBD)may have an increased risk of venous thrombosis(VTE).PubMed,ISI Web of Knowledge and Scopus were searched to identify studies investigating the risk of VTE and the prevalence of acquired and genetic VTE risk factors and prothrombotic abnormalities in ***,IBD patients have a two-to fourfold increased risk of VTE compared with healthy controls,with an overall incidence rate of 1%-8%.The majority of studies did not show significant differences in the risk of VTE between Crohn’s disease and ulcerative *** acquired factors are responsible for the increased risk of VTEin IBD:inflammatory activity,hospitalisation,surgery,pregnancy,disease phenotype(e.g.,fistulising disease,colonic involvement and extensive involvement)and drug therapy(mainly steroids).There is also convincing evidence from basic science and from clinical and epidemiological studies that IBD is associated with several prothrombotic abnormalities,including initiation of the coagulation system,downregulation of natural anticoagulant mechanisms,impairment of fibrinolysis,increased platelet count and reactivity and dysfunction of the *** genetic alterations are not generally found more often in IBD patients than in nonIBD patients,suggesting that genetics does not explain the greater risk of VTE in these *** VTE may have clinical specificities,namely an earlier first episode of VTE in life,high recurrence rate,decreased efficacy of some drugs in preventing further episodes and poor *** should be aware of these risks,and adequate prophylactic actions should be taken in patients who have disease activity,are hospitalised,are submitted to surgery or are undergoing treatment.

关键词： Acquired Genetic prothrombotic Venous thrombosis R

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