相关实验视频
中心静脉导管 (WARP) 的癌症患者的华法林血栓预防:一个开放式随机试验
Annie M Young1, Lucinda J Billingham, Gulnaz Begum
1Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK. a.young@bham.ac.uk
Lancet (London, England)
|February 17, 2009
概括
华法林在接受化疗的癌症患者中不会预防导管相关的血栓形成. 剂量调整后的华法林比固定的剂量有好处,但总的来说,应考虑使用较新的治疗方法进行血栓预防.
科学领域:
- 在瘤学瘤学.
- 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:
- 关于在癌症患者中使用中央静脉导管 (CVC) 进行血栓预防的抗凝剂使用存在争议.
- 评估华法林的疗效和最佳剂量以预防导管相关血栓形成至关重要.
研究的目的:
- 为了评估华法林是否能减少与无华法林相比,在接受化疗的癌症患者中减少与导管相关的血栓形成.
- 为了确定华法林的剂量是否影响其血栓预防作用.
主要方法:
- 一个随机对照试验,涉及1590名癌症患者,在68个英国中心进行了CVC.
- 患者被分配为没有华法林,固定剂量华法林 (1毫克/天),或剂量调整的华法林 (INR 1.5-2.0).
- 主要结局是放射学证明,症状性导管相关血栓;使用治疗意图分析.
主要成果:
- 与没有华法林相比,华法林 (任何剂量) 并没有显著减少与导管相关的血栓形成 (6%与6%相比;p=0.98).
- 剂量调整后的华法林在预防血栓形成方面优于固定剂量华法林 (3%对7%;p=0.002).
- 主要出血事件很少见,华法林有轻微的过量;结合血栓和出血终点或生存益处没有显著差异.
结论:
- 与没有华法林相比,预防性华法林在癌症患者中不会减少症状性导管相关血栓.
- 剂量调整后的华法林显示出与固定的剂量相比的潜在益处,但整体疗效有限.
- 在这种患者群体中,建议考虑使用较新的抗凝药治疗来进行血栓预防.
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