β地中海贫血高凝状态的发病机制及相关临床研究进展

Advances in pathogenesis and correlated clinical research of hypercoagulability in β thalassemia

该文综述了β地中海贫血(简称β地贫)患者高凝状态的发病机制,包括血小板活化、红细胞膜改变、血管内皮细胞粘附分子表达增加及铁过载等;详述了β地贫患者高凝状态及血栓形成的临床依据、脾切除术对高凝状态的影响以及相关临床表现;讨论了β地贫中间型患者血栓栓塞性事件的防治措施,包括输血以提高血红蛋白水平,避免或延迟脾切除术以及一些处在探索阶段的治疗方式。

This article summarizes the pathogenesis of hypercoagulability in β thalassemia patients, including platelet activation, alteration of red blood cell membranes, abnormal expression of adhesion molecules on vascular endothelial cells and iron overload. Clinical evidence, clinical manifestations of hypercoagulable state and thrombosis in β thalassemia and the effect of splenectomy on hypercoagulable state were reviewed. Strategies to prevent and treat the thromboembolic events in β-thalassemia intermedia are also discussed, including transfusion therapy to raise hemoglobin levels, avoidance or delay of splenectomy and a number of treatments in the exploration.