| Background and purpose: Polycythemia vera is a clonal hematopoietic stem cell disease.One or more lines of myeloid cells,mainly red blood cells,are abnormally cloned and proliferated,with the risk of transforming into myelofibrosis or leukemia.Thromboembolism and bleeding events are the common causes of treatment or death.The purpose of this study is to retrospectively analyze the clinical characteristics of 59 PV patients,compare the clinical characteristics of thromboembolism and bleeding events,and analyze the risk factors of thromboembolism and bleeding events.Methods: The clinical data of 59 patients with polycythemia vera hospitalized in the Department of Hematology,First Affiliated Hospital of Guangxi Medical University from January 2015 to February 2021 were collected and divided into three groups according to thrombosis and bleeding complications: thrombosis group,bleeding group and non-thrombosis/bleeding group.General data(gender,age),blood routine,some biochemical indexes,coagulation function,erythropoietin,Janus kinase 2,abdominal ultrasound,cardiovascular risk factors(smoking history,diabetes,hypertension,hyperlipidemia)were used as observation indexes for univariate analysis,and independent risk factors of thromboembolism and bleeding events were analyzed by binary Logistic regression analysis.Results:1.Among 59 PV patients,29 were male(49.2%),30 were female(50.8%),and the ratio of male to female was 1.00: 1.03.The average age was(57.1± 10.6)years,ranging from 31 to 81 years old,with 23 cases(39.0%)over60 years old and 36 cases(61.0%)under 60 years old.JAK2 V617 F was positive in 50 cases and negative in 9 cases.CALR,MPL and BCR-ABL genes were detected in 34,33 and 36 patients respectively,all of which were negative.2.There were no significant differences in gender,incidence of thrombosis,incidence of bleeding,Hb,HCT,LDH,APTT,Pt and cardiovascular risk factors between JAK2 V617 F positive PV patients and JAK2 V617 F negative PV patients(P > 0.05).The age,splenomegaly,leukocyte count and platelet count of positive JAK2 V617 F patients were higher than those of negative PV patients(P<0.05).3.Of the 59 PV patients,19(32.2%)had thromboembolism,among which17(89.5%)had arterial thrombosis and 2(10.5%)had venous thrombosis.Univariate analysis showed that there were significant differences in leukocyte count,platelet count and cardiovascular risk factors between thrombotic group and non-thrombotic/hemorrhagic group(P<0.05).Multivariate Logistic regression analysis showed that the risk of thromboembolism in PV patients with cardiovascular risk factors was 6.134 times higher than that without cardiovascular risk factors.The risk of thromboembolism increased by 15.7%for each unit of leukocyte count and 0.3% for each unit of platelet count,suggesting that leukocyte count,platelet count and cardiovascular risk factors are independent risk factors for thromboembolism in PV patients(OR>1,P<0.05).4.The incidence of bleeding events in PV patients is 11.6%,which is lower than that of thrombosis.The factors affecting bleeding events need further exploration.Conclusion: 1.Thrombosis and bleeding are serious complications of PV patients.Because the incidence of bleeding is lower than that of thrombosis,it is often ignored by clinicians.2.The incidence of thrombosis in PV patients is higher,and arterial thrombosis is more common than venous thrombosis,among which cerebrovascular events are the most common.3.High white blood cell count,high platelet count and cardiovascular risk factors are independent risk factors of thromboembolism in PV patients.It is suggested that clinical attention should be paid and early intervention should be made. |
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