静脉血栓栓塞症患者的长期治疗
1Department of Medicine, McMaster University, McMaster Clinic, Henderson General Hospital, Hamilton, Ontario, Canada. kearonc@mcmaster.ca
Circulation
|September 2, 2004
概括
个性化抗凝剂治疗持续时间是长期静脉血栓塞栓症 (VTE) 管理的关键. 治疗时间长度取决于静脉瘤风险因素和出血潜力,指导患者最佳治疗结果的决策.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 药理学 药理学 是一个学科.
背景情况:
- 静脉血栓塞栓症 (VTE) 的长期管理主要涉及确定抗凝药治疗的最佳持续时间.
- 目前的指导方针经常使用维生素K (VK) 抗剂进行延长的静脉瘤治疗.
研究的目的:
- 概述VTE患者长期抗凝药治疗的个性化策略.
- 根据VTE复发风险和出血风险来定义治疗持续时间.
主要方法:
- 基于诱发因素的风险分层 (例如手术,癌症,异常病).
- 考虑影响复发和出血的临床因素 (例如肺栓塞,恶性瘤,患者偏好).
- 确定VK抗剂治疗的最佳强度 (目标INR2.0-3.0).
主要成果:
- 由主要可逆因素引起的静脉瘤发作:典型的治疗时间为3个月.
- 未引起的静脉瘤或与不可逆转因素 (如癌症) 相关:至少6个月,通常是无限期的治疗.
- 中级风险VTE:治疗3-6个月.
结论:
- 个性化的VTE治疗持续时间至关重要,平衡复发和出血风险.
- 具体的临床表现和患者因素指导治疗长度.
- 低分子量肝素和口服直接血栓激素抑制剂是长期VTE预防的替代方案.
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