静脉血栓栓塞研究的既往与现今及未来

Research in the field ofvenous thromboembolism： history, current perspectives and future directions

静脉血栓栓塞症（VTE）是继冠心病和中风后排名第三的最常见的心血管疾病。在过去的100年中，对于血液凝固过程及其调控机制的深入了解推进了VTE的诊断和治疗方法。1860年制定的魏尔肖三定律直今仍然是有效的，即VTE是由于血管壁受损、血液流动减慢和血液成分改变造成的。流行病学和临床科学现在也已经确定了V‘rE的多个后天获得性危险因素，如高龄、肿瘤、手术、外伤、固定、怀孕和使用口服避孕药等。随着遗传研究技术的快速发展，一些基因被确定与VTE的家族聚集性有关，与VTE相关的基因变异也逐渐被发现。遗传因素和后天获得性的危险因素在血栓的发展中相互作用。新型实验诊断项目能够帮助人们早期判断高凝状态。因此，为减少全球VTE负担，对VTE的预防，风险评估，诊断和治疗将更为重要。

Venous thromboembolism is the third most common cardiovascular disease after coronary heart disease and stroke. Over the past 100 years advances in the understanding of the mechanism of blood coagulation and its regulation have translated into development of new diagnostic methods and treatments for VTE. Virchow＇s triad formulated in 1860 is still valid, i.e. VTE is due to damage to the vessel wall, slowing of blood flow and change of the blood constituents. Epidemiological and clinical sciences have identified acquired risk factors for VTE such as old age, cancer, surgery, trauma, immobilization, pregnancy, and oral contraceptive use. Several genes have been linked to familial aggregation of VTE and the list of genetic variants associated VTE is growing fast due to the rapid technological advances in genetic studies. Genetic factors and acquired risk factors interact with each other in the development of thrombosis. New diagnostic items of coagulation were used in clinic to reveal high coagulation situation. Research will therefore be continued which will be important in identifying even better opportunities for risk assessment, prevention, diagnosis, and treatment of VTE in order to decrease the global burden of VTE.