静脉血栓栓塞和癌症:风险和结果
1Department of Medicine, McMaster University, Hamilton, Ontario, Canada. alee@mcmaster.ca
Circulation
|June 20, 2003
概括
癌症患者面临高风险的静脉血栓栓塞 (VTE). 在癌症患者的长期VTE治疗中,低分子量肝素可能比口服抗凝剂提供更好的治疗选择.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 血栓形成研究研究
背景情况:
- 癌症及其治疗方法显著增加了静脉血栓栓塞 (VTE) 的风险.
- 癌症患者的VTE风险因素包括瘤类型,阶段,抗瘤剂,年龄,手术和固定.
- 在患有VTE的癌症患者中,不建议对遗传性血栓友爱症进行查.
研究的目的:
- 审查癌症患者静脉血栓塞栓症 (VTE) 的风险因素,管理和结果.
- 在癌症的背景下评估VTE的治疗选择.
- 讨论隐性恶性瘤和特异性血栓瘤之间的关系.
主要方法:
- 对癌症相关血栓形成现有证据的审查.
- 分析影响癌症患者静脉瘤风险的因素.
- 讨论相关临床试验的发现,如CLOT研究.
主要成果:
- 与VTE相关的常见恶性瘤包括乳腺癌,结肠癌和肺癌;胰腺癌,卵巢癌和脑癌显示出较高的相对风险.
- 隐藏的恶性瘤可以呈现为异常性血栓形成,但在VTE患者中,广泛的癌症查通常不需要.
- 与口服抗凝剂相比,低分子量肝素 (LMWH) 在癌症患者中显示出作为一种优越的长期治疗VTE的潜力,正如CLOT研究所建议的那样.
结论:
- 由于复发性VTE和癌症本身,患有VTE的癌症患者的预期寿命缩短.
- 在患有静脉血栓炎的癌症患者中,延长抗凝剂治疗增加了复发和出血的风险.
- 低分子量肝素 (LMWH) 可能是癌症患者的长期抗凝治疗的首选治疗方法,而抗凝剂的抗瘤作用正在研究中.
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