静脈性血栓塞栓症の自然史について
1McMaster Clinic, Henderson General Hospital, Hamilton, Ontario, Canada. kearonc@mcmaster.ca
Circulation
|June 20, 2003
まとめ
大抵の深静脈血栓症 (DVT) は,小腿から発生し,しばしば介入なしに治る. しかし,近親 DVT と肺栓塞 (PE) は,死亡率や,後血栓症候群のような長期的な合併症を含む重大なリスクを伴う.
科学分野:
- 血管医学 血管医学とは
- 血液学 ヘマトロジ
- 心臓病学 心臓病学
背景:
- 深い静脈血栓症 (DVT) は,通常,小牛で始まり,自発的な解消が頻繁に起こります.
- 仔牛のDVTは,めったに足の症状や肺栓塞 (PE) を引き起こさないが,プロキシマル拡張のリスクは,プロトロンボティックな刺激によって増加する.
研究 の 目的:
- 静脈血栓塞栓症 (VTE) の自然史,臨床表現,およびアウトカムを解明する.
- DVTの解像度,PEの発達,および長期的な続変に影響を与える要因を理解する.
主な方法:
- DVTとPEに関する既存の文献のレビュー.
- 血栓の位置,解消率,臨床結果に関する患者データの分析.
- 再発および合併症の危険因子の特定.
主要な成果:
- 大半のDVTは,小児期に始まり,自発的に解消する可能性があるが,近接拡張はPEリスクを増加させる.
- 近親DVTは,抗凝固剤でゆっくりと解消する;癌と大きな初期血栓は解消を妨げます.
- PEは死亡リスクを持ち,合併症には右心室機能不全,肺高血圧,再発性血栓症,特に高リスクグループが含まれます.
結論:
- VTEは,診断時にしばしば足と肺の両方の部位を含む.
- 結果は,血栓負荷,患者併発症 (がんなど),遺伝的要因によって影響を受けます.
- 長期的なリスクには,ポストトロンボシス症候群と再発性VTEが含まれ,慎重な管理とリスク因子評価を必要とします.
関連する概念動画
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
2.6K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.6K
01:16Vascular Spasm
4.9K
The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
4.9K
01:22Formation of the Platelet Plug
6.2K
The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
6.2K
01:30Peripheral Artery Disease I: Introduction
659
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
659
01:30Venous Thrombosis I: Introduction
822
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
822
01:15Ischemic Stroke l: Introduction
44
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
44