在患有肝素诱导的血小板缺血症患者的阿尔加特罗班抗凝剂治疗中
B E Lewis1, D E Wallis, S D Berkowitz
1Loyola University Medical Center, Maywood, Illinois, USA. blewis@LUMC.edu
Circulation
|April 11, 2001
概括
阿尔加特罗班有效治疗肝素诱导的血小板缺血 (HIT) 和带有血栓综合征 (HITTS) 的HIT,减少死亡和新血栓形成等不良事件. 这种直接的血栓激素抑制剂可以改善临床结果,而不会增加出血风险.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 氨酸诱导的血小板缺血 (HIT) 是氨酸治疗的严重免疫中介并发症.
- HIT可能导致严重的后果,包括血小板缺血和血栓形成.
- 阿尔加特罗班是一种直接的血栓抑制剂,用于评估HIT和与血栓形成综合征 (HITTS) 相关的HIT.
研究的目的:
- 评估阿斯拉夫罗班作为HIT或HITTS患者抗凝剂的疗效和安全性.
- 为了比较阿格拉斯罗班治疗与历史对照对象的临床结果.
主要方法:
- 一项前性,历史对照性研究,涉及HIT (n=160) 或HITTS (n=144) 患者,这些患者接受了 argatroban.
- 调整了阿尔加特罗班的剂量,以保持激活的部分血栓形成时间 (aPTT) 的1.5至3.0倍.
- 结果与37天的193名历史对照对象进行了比较.
主要成果:
- 阿尔加特罗班显著降低了HIT患者死亡,截肢或新血栓的复合终点 (25.6%与38.8%,P=0.014).
- 时间到事件分析在HIT和HITTS的复合终点 (P=0.010和P=0.014,分别) 中都偏爱了argatroban.
- 阿尔加特罗班治疗导致更快的治疗aPTT成就和血小板数的更快的增加,与对照组相比,出血事件的发生率相似.
结论:
- 阿尔加特罗班抗凝剂改善了肝素诱导的血栓塞缩症患者的临床结果.
- 与历史对照组相比,阿斯巴特罗班治疗不会增加出血风险.
- 阿加特罗班是一种有效的治疗选择,用于管理HIT和HITTS.
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