静脈性血栓栓塞栓症を予防する 医療患者の静脈性血栓塞栓
Alain Leizorovicz1, Patrick Mismetti
1Unité de Pharmacologie Clinique, EA 3736, Université Claude Bernard Lyon I, Rue Guillaume Paradin, 69376 Lyon Cedex 08, France. al@upcl.univ-lyon1.fr
Circulation
|December 16, 2004
まとめ
低分子量ヘパリン (LMWH) または不分化ヘパリン (UFH) の予防は,急性疾患の医療患者における静脈血栓栓塞栓症 (VTE) のリスクを大幅に減少させます. 証拠は,これらの抗凝固剤を2週間定期的に使用することで,VTEの発生を防ぐことを支持しています.
科学分野:
- 内科内科は,内科の内科である.
- 心臓病学 心臓病学
- 薬理学 薬理学とは
背景:
- 急性疾患の医療従事者は,静脈血栓塞栓症 (VTE) の高リスクに直面しています.
- VTEの予防は,患者の異質性とリスク評価の課題のために,この集団では十分に活用されていません.
- 最近の臨床試験は,抗凝固剤のシステマティックな使用を支持する証拠を提供します.
研究 の 目的:
- 急性疾患の医療患者における血栓予防療法の有効性を評価する.
- 低用量低分子量ヘパリン (LMWH) と未分化ヘパリン (UFH) の使用に関する証拠をまとめます.
主な方法:
- 3つの大規模かつよく管理された臨床試験 (メデノックス,プレヴェント,アルテミス) の分析.
- UFHとLMWHを比較した約5000人の内科患者のメタアナリシスを含む.
- 予防治療の持続時間に関する証拠のレビュー.
主要な成果:
- LMWHとフォンダパリヌックスは,異なるリスク集団でVTEの発生を一貫して50%減少させました.
- メタアナリシスは,UFHと比較して,LMWHによる深静脈栓塞と肺栓塞が減少する傾向を示した.
- 研究における一貫した結果が,抗凝固剤の有効性を支持しています.
結論:
- LMWHまたはUFHのシステマティックな使用は,急性疾患の医療患者におけるVTE予防のために推奨されます.
- UFHとLMWHによる予防治療は,臨床試験のデータに基づいて2週間推奨されます.
- 証拠は,この患者グループにおいて,より広範な血栓予防療法を実施することを支持しています.
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