| Among three mechanisms of thrombosis, it is well known that damage of cardiovascular endothelial and change of blood flow state are two key factors of thrombosis and their mechanism of action is more clear. Recent years, further studies are made to understand hypercoagulability. In factors currently known to cause hypercoagulability, activated protein C resistance (APCR) is a common cause that reduce the physiological anticoagulant and decrese activity, threrfore, it is one of the high risks for venous thromboembolism (VTE). APCR has been found that20%to60%of patients with no obvious incentive reason, and above90%individuals with APCR is caused by the Leiden V factor (FVL), furthermore, about80%of APCR patients are suffer from deep vein thrombosis (DVT). In western population,21.4%(20%to23%) of initial VTE incidence is attributed to FVL. This study compared the incidence of VTE in Yunnan Province and other regions of the country, screening whether VTE patients in Yunnan Province carry FVL, a single nucleotide polymorphisms of factor V, and discuss the relationship between FVL and VTE in Yunnan plateau region.In the process of coagulation, FV is used as the activation of the coagulation factor X (FXa) auxiliary factor, accelerating activation of prothrombin by FXa. Coagulant activity of FVa is removed by cleavage at Arg306, Arg506, Arg679and/or Lys994. Bertina found Arg506Gln mutations (FV Leiden) associated with the APC resistance (APCR). Inhibition of APC for FVa Gln506is only1/10of its normal FVa inhibition capacity. Different populations of Europe FVL carrying rate is between2%～15%. FVL in Caucasian race is the most common, more than90%of caucasians are hereditary activated protein C resistance. In addition, it is also found in the Middle East and India. Currently, in Africa, Asia, America and Australia, FVL has been found, and APCR in these areas may be associated with other mutations.Objective:Explore the relationship between VTE disease in Yunnan province and FVL; to compare VTE disease in Yunnan province with other areas in China; and analyze whether VTE disease could attribute to factors of Yunnan plateau environment.Methods:From January2010to July2011, research collected97patients with venous thromboembolism (both diagnosed by venography or vascular ultrasound in the First Affiliated Hospital of Kunming Medical University) and100normal people performed in routine physical examination as control group. Related primer of FV is design, corresponding segments of FV are amplified by polymerase chain reaction (PCR), and then segments are detected using restriction fragment length polymorphism (PCR-RFLP) after purification, and PCR fragments are amplified and sequenced directly in the end.Results:1. There are3cases with FVL heterozygote in VTE group, but no FVL homozygote was observed, while no FVL heterozygote or homozygote was found in the control group. Distribution frequency of FVL in VTE group is higher than that in control group, but no obvious statistical difference is demonstrated (P>0.05).2. Other causes referring to hypercoagulability, such as red blood cell, haematoglobin and platelet can not be distinguished between VTE group and control group(P>0.05).Conclusion:1. Three cases of heterozygous carriers of Factor V Leiden are observed in VTE group. FVL is rarely found China and Asia region. It can not be excluded that FVL may involve in Yunnan regional or environmental factors, or may associate with VTE in a particular geographical or population distribution area. 2. It is not rigorous to conclude that VTE in Yunnan Province is associated with Factor V Leiden, whether they are relevant or irrelevant can not be concluded right now. Further more researches are needed. |
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