clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2024-102-8-655-660clinmed-927Research ArticleЗАМЕТКИ И НАБЛЮДЕНИЯ ИЗ ПРАКТИКИNOTES AND OBSERVATIONS FROM PRACTICEНовая тромбофилия в результате мутации фибриногенаNew thrombophylia as a result of fibrinogen mutationhttps://orcid.org/0000-0003-1453-7290ХлевчукТ. В.KhlevchukT. V.

Хлевчук Татьяна Васильевна — канд. мед. наук, доцент кафедры госпитальной терапии №1 ИКМ им. Н.В. Склифосовского

Москва 

Tatyana V. Khlevchuk — Candidate of Medical Sciences, Associate Professor of the Department of Hospital Therapy No. 1

Moscow

khlevchuk@inbox.ruhttps://orcid.org/0000-0002-3135-3680СтаржевскаяА. А.StarzhevskayaA. A.

Старжевская Анастасия Александровна — аспирант кафедры госпитальной терапии №1

Москва

Anastasia A. Starzhevskaya — postgraduate student of the Department of Hospital Therapy No. 1

Moscow

https://orcid.org/0009-0002-8499-1077РоговаЕ. А.RogovaE. A.

Рогова Елизавета Андреевна — студентка 6-го курса 

Москва

Elizaveta A. Rogova — a 6th—year student 

Moscow

https://orcid.org/0000-0002-2161-2140АгеевА. А.AgeevA. A.

Агеев Антон Александрович — ассистент кафедры госпитальной терапии №1 

Москва

Anton A. Ageev — Assistant of the Department of Hospital Therapy No. 1 

Moscow

https://orcid.org/0000-0001-7938-1763КондратьеваТ. Б.KondratyevaT. V.

Кондратьева Татьяна Борисовна — канд. мед. наук, доцент кафедры госпитальной терапии №1 

Москва

Tatyana B. Kondratyeva — Candidate of Medical Sciences, Associate professor of the Department of Hospital Therapy No. 1

Moscow

https://orcid.org/0000-0003-4802-6544АксеноваМ. Б.AksenovaM. B.

Аксенова Марианна Борисовна — канд. мед. наук, доцент кафедры госпитальной терапии №1

Москва

Marianna B. Aksenova — Candidate of Medical Sciences, Associate Professor of the Department of Hospital Therapy No. 1

Moscow

https://orcid.org/0000-0003-3979-5122ПоповР. Г.PopovR. G.

Попов Ростислав Григорьевич — студент 3-го курса

Москва

Rostislav G. Popov – a 3rd year student

Moscow

https://orcid.org/0009-0004-3822-818XКарповаП. А.KarpovaР. A.

Карпова Полина Андреевна — студентка 3-го курса

Москва 

Polina A. Karpova — 3rd year student 

Moscow

https://orcid.org/0000-0002-3496-6466ПоповаЛ. В.PopovaL. V.

Попова Людмила Викторовна — канд. мед. наук, доцент кафедры госпитальной терапии №1

Москва

Lyudmila V. Popova — Candidate of Medical Sciences, Associate Professor of the Department of Hospital Therapy No. 1 

Moscow

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Институт клинической медицины им. Н.В. Склифосовского; Всеросийская Ассоциация по изучению тромбозов, гемостаза и патологии сосудов им. А.А. Шмидта–Б.А. КудряшоваРоссияI.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University), Institute of Clinical Medicine named after N.V. Sklifosovsky; Russian Association on Thrombosis, Hemostasis and Vascular Pathology A.A. Schmidt–B.A. KudryashovRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Институт клинической медицины им. Н.В. СклифосовскогоРоссияI.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University), Institute of Clinical Medicine named after N.V. SklifosovskyRussian Federation2024120120251028655660Copyright © Хлевчук Т.В., Старжевская А.А., Рогова Е.А., Агеев А.А., Кондратьева Т.Б., Аксенова М.Б., Попов Р.Г., Карпова П.А., Попова Л.В., 20252025Хлевчук Т.В., Старжевская А.А., Рогова Е.А., Агеев А.А., Кондратьева Т.Б., Аксенова М.Б., Попов Р.Г., Карпова П.А., Попова Л.В.Khlevchuk T.V., Starzhevskaya A.A., Rogova E.A., Ageev A.A., Kondratyeva T.V., Aksenova M.B., Popov R.G., Karpova Р.A., Popova L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/927

Фибриноген (ФГ) — фактор I свертывающей системы крови — важное звено каскада гемокоагуляции. Его основная физиологическая функция — участие в заключительной стадии процесса свертывания крови, когда растворимый фибриноген под действием тромбина и фактора XII превращается в нерастворимый фибрин. Появляется все больше данных о врожденных нарушениях синтеза и/или структуры фибриногена, дефицит которого представлен в 9,3 % случаев редких нарушений свертываемости крови. Разнообразие фенотипов при врожденном нарушении структуры ФГ, проявляющееся склонностью к кровоточивости и/или тромбозам, преимущественно в артериальном русле (инфаркты, инсульты), определяет современные трудности диагностики. В связи с этим необходимо подробнее исследовать дефекты ФГ у пациентов. В нашей работе представлен обзор современной литературы о вкладе фибриногена в патогенез сердечно-сосудистых заболеваний. В качестве подтверждения данной информации приведен клинический случай молодой женщины 36 лет, у которой развитие инфаркта миокарда без обструктивного поражения коронарных артерий произошло на фоне носительства гомозиготной мутации фибриногена (FGB −455 G/A).

Fibrinogen (FG), factor I of the blood coagulation system, is a critical component of the hemostatic cascade. Its primary physiological function involves the final stage of blood coagulation, where soluble fibrinogen is converted into insoluble fibrin by thrombin and factor XII. Increasing data highlight congenital disorders of fibrinogen synthesis and/or structure, with deficiencies found in 9.3% of rare blood coagulation disorders. The variety of phenotypes in congenital FG structural disorders, characterized by a tendency for bleeding and/or thrombosis, primarily in the arterial system (infarcts, strokes), complicates modern diagnosis. Therefore, a detailed study of FG defects in patients is required. This article reviews current literature on the role of fibrinogen in the pathogenesis of cardiovascular diseases. A clinical case is presented involving a 36-year-old woman who experienced a myocardial infarction without obstructive coronary artery disease, linked to a homozygous mutation in fibrinogen (FGB −455 G/A).

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The authors declare that there are no conflicts of interest present.