| Deep vein thrombosis(DVT),caused by alterations in venous homeostasis,is the third most common cause of cardiovascular mortality.Untreated lower limb venous thrombosis can cause serious consequences,which can lead to death or serious disability due to pulmonary embolism or post-thrombotic syndrome,which requires prompt diagnosis and treatment.Environmental and genetic risk factors lead to the risk of venous thrombosis is different in different people,especially inflammation related genetic variation(such as IL-1,IL-4,IL-6,etc.)is closely related to individual lower limb venous thrombosis susceptibility,further analyze and understand the environment,genetic factors interact,contribute to a deeper understanding of the pathogenesis of lower limb venous thrombosis.Inner Mongolia is the settlement of the Mongolian people,most of whom live on grazing and live high in fat.At the same time,under the influence of genetic genes and other related factors,the obesity rate of the Mongolian population is also significantly higher than that of the Han people with different living habits.Multiple studies have shown that factors such as obesity and hyperlipemia can affect the formation of VTE.At present,there is no Mongolian and han people between lower limb venous thrombosis risk and treatment effect difference,so this study will be in Tongliao city patients of lower limb vein thrombosis risk,thrombosis type,genetic factors,and treatment differences between the Mongolian and Chinese ethnic analysis,to explore targeted prevention and treatment strategy to provide research data.Obsjective:Through statistical analysis of the differences between Mongolian and Han patients in physical condition,age of onset,treatment effect,and gene polymorphism of inflammatory related cytokines among the hospitalized patients with venous thrombosis of lower limbs in the Affiliated Hospital of Tongliao University for Nationalities in Inner Mongolia in the past two years,the difference in the responsiveness of Mongolian and Han patients with venous thrombosis of lower limbs to anticoagulant treatment was explored in order to find a more suitable prevention and treatment scheme.Methods:From January 2020 to December 2021,313 inpatients with lower extremity venous thrombosis were collected from the Affiliated Hospital of Tongliao Minzu University in Inner Mongolia,including 172 Mongolian(average age 62.3 years)and 141 Han(average age 64.7 years).Clinical basic information of patients’ dietary habits and basic diseases were collected,and the basic situation of lower limb venous thrombosis was assessed by Caprini score,imaging test,and D-dimer test.In the first phase,for 7 days,the D-dimer content test was evaluated;in the second phase,the patients with insignificant efficacy(216 cases)had combined thrombolysis and anticoagulant treatment for 7 days;the patients with insignificant efficacy(108 cases),supplemented by anticoagulant treatment for 7 days,tested the comparative efficacy of D-dimer content,pathological observation and thrombus component detection;follow-up statistical recurrence of Mongolian and Han people,and statistical and comparative analysis.A total of 50 Han patients and 50 Mongolian patients were selected to sequence the thrombus and analyze the SPN polymorphisms of IL-1,IL-6 and TNF.Results:(1)Among the hospitalized patients enrolled with lower extremity venous thrombosis,the Mongolian patients with hypertension,obesity and perennial drinking and smoking were significantly higher than those of the Han patients,and the average age was slightly younger.(2)The treatment effect of LMWH calcium on Mongolian patients was significantly better than that of Han patients,and the effective control rate of Han patients was as high as 40.2% and only 19.9%.However,the effective control rate of Mongolian patients(54.4%)and Han patients(46.0%)patients showed good treatment effect.Patients with congenital genetic diseases,diabetes,and coronary heart disease have poor outcomes.(3)Patients with poor combination therapy had surgery and anticoagulant adjuvant therapy,and the recurrence rate of Mongolian(10.1%)and Han(8.2%)patients were relatively low.However,during the postoperative follow-up,it was found that 27 Mongolian patients stopped taking medicine after 1 month after the surgery,including30 Han patients,and the recurrence rate of Mongolian patients was as high as 62.7%,which was significantly higher than that of Han patients(40%,P <0.05).(4)The study found that Mongolian patients were mainly 23 / 47;among Han patients,mixed thrombosis was mainly 32 / 61.The thrombus composition test found that the Mongolian patients had higher content of fibrin and fibrinogen degradation products,but also lower content of homocysteine compared with the Han nationality.(5)Gene polymorphism analysis found that the gene mutation rate of IL-1 A2 was significantly higher than that of Han patients,and the dominant gene of IL-1 A2 locus was significantly increased,which further aggravated the activity of IL-1,which may lead to higher inflammatory response in patients compared with Han patients,thus improving its dependence on anticoagulation drugs.Conclusion:1.Due to ethnic differences and life habits,the proportion of patients with hypertension and obesity in the Mongolian people suffering from lower limb venous thrombosis is high,and their age tends to be significantly younger;2.The therapeutic effect of anticoagulant drugs in Mongolian patients is significantly better than that of Han patients;and the recurrence rate of Mongolian patients is significantly higher than that of Han patients,showing high drug resistance;3.Mongolian patients are mainly have red thrombosis in thrombosis type;and fibrinogen and fibrinogen degradation products are significantly higher than those of Han patients,which is speculated to be related to Mongolian heredity and long-term high salt and high fat eating habits or bad habits such as drinking and smoking.4 The mutation rate of Mongolian patients at IL-1 A2 is significantly higher than that in Han patients,while the mutation at IL-1 A2 may exacerbate the level of inflammatory response in vivo,which in turn is significantly higher in drug dependence than in Han people. |
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