在医疗患者中预防静脉血栓栓塞
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
概括
用低分子量肝素 (LMWH) 或未分离肝素 (UFH) 进行预防,可显著降低急性病患者静脉血栓塞栓症 (VTE) 风险. 证据支持在两周内系统使用这些抗凝剂来预防VTE事件.
科学领域:
- 内部医学 内部医学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性病患者面临着高风险的静脉血栓塞栓症 (VTE).
- 由于患者的异质性和风险评估的挑战,这种人群中对静脉瘤的预防没有充分利用.
- 最近的临床试验提供了支持系统使用抗凝剂的证据.
研究的目的:
- 在急性病患者中评估血栓预防的疗效.
- 总结使用低剂量低分子量肝素 (LMWH) 和未分离肝素 (UFH) 的证据.
主要方法:
- 分析了三项大型,受良好控制的临床试验 (MEDENOX,PREVENT,ARTEMIS).
- 包括近5000名内科病人的元分析,比较UFH和LMWH.
- 对预防性治疗持续时间的证据的审查.
主要成果:
- 在不同的风险人群中,LMWH和 fondaparinux 始终将VTE 事件降低了50%.
- 一项元分析显示,与UFH相比,LMWH的深静脉血栓和肺栓塞减少的趋势.
- 跨研究一致的发现支持抗凝固药的有效性.
结论:
- 建议系统使用LMWH或UFH用于急性病患者的VTE预防.
- 根据临床试验数据,建议在两周内使用UFH和LMWH进行预防治疗.
- 证据支持在这个患者群体中更广泛地实施血栓预防治疗.
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