D-二聚合物水平和复发性静脉血栓栓塞的风险
Sabine Eichinger1, Erich Minar, Christine Bialonczyk
1Department of Internal Medicine I, University of Vienna, Austria. sabine.eichinger@akh-wien.ac.at
JAMA
|August 28, 2003
概括
患有首次静脉血栓塞栓症 (VTE) 的患者在停止抗凝药后具有低D-二次体水平,其VTE复发的风险降低. 这一发现有助于评估个体患者未来发生血栓的风险.
科学领域:
- 血液学 血液学 血液学
- 临床医学 临床医学
- 血栓形成研究研究
背景情况:
- 对于静脉血栓塞栓症 (VTE) 患者来说,对血栓型风险因素的查是常见的.
- 评估个体VTE复发风险是复杂的,因为许多风险因素.
- 需要一种实验室方法来评估多因素血栓友症.
研究的目的:
- 为了前性地研究D-二聚物水平与复发性VTE的风险之间的关联.
- 评估D-二聚体作为凝血激活和纤维素分解在VTE复发预测的全球标志物.
主要方法:
- 一项前性队列研究,对610名患者进行了首次自发性静脉动脉突发症,接受了口服抗凝剂治疗.
- 在停止服用口服抗凝药后,测量D-二聚物水平.
- 患者在平均38个月的时间内被监测VTE复发.
主要成果:
- 在13%的患者中发生了复发性VTE.
- 较高的D-二聚合物水平与复发性静脉瘤 (553 ng/mL vs 427 ng/mL,P =.01) 有显著的关联.
- 患有D-二元体<250 ng/mL的患者在2年内复发的累积概率显著降低 (3.7%对11.5%,P=.001),并且复发的相对风险降低了60%.
结论:
- 在停止服用口服抗凝药后,D-二聚合物水平低于250ng/mL表明VTE复发的风险较低.
- 测量D-二次体是有价值的工具,用于风险分层在VTE病史的患者.
- 这一发现支持对VTE复发的个性化风险评估.
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