治疗抗凝剂在COVID-19中的作用:当前情况
Mandeep Singh Rahi1, Jay Parekh2, Prachi Pednekar3
1Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Lawrence and Memorial Hospital, New London, CT 06320, USA.
Hematology reports
|June 27, 2023
概括
治疗剂量的肝素可以减少血栓事件,并改善住院COVID-19患者的器官支持,但死亡率的好处是不一致的. 现在的指导方针建议在选择的中度病患者中使用它.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 药理学 药理学 是一个学科.
背景情况:
- COVID-19与显著的血栓性并发症有关,在各个变种中存在不同的风险.
- 肝素表现出抗炎和抗病毒特性,促使对其非抗凝效应进行调查.
- 升级剂量抗凝药,特别是治疗剂量肝素,正在探索住院COVID-19患者的血栓预防.
研究的目的:
- 审查目前关于在住院COVID-19患者中使用抗凝剂的证据.
- 为了评估治疗剂量肝素对血栓预防的疗效.
- 总结随机对照试验和元分析的发现.
主要方法:
- 随机对照试验 (RCT) 和元分析的审查.
- 使用自适应多平台设计和贝叶斯分析的研究分析.
- 专注于涉及中度至重症COVID-19患者的试验,这些患者的D-二次数升高和出血风险低.
主要成果:
- 大多数试验显示,改善了无器官支持的日期,并减少了血栓事件,主要是在非危急病患者中.
- 在各个研究中,死亡率的好处是不一致的.
- 中期剂量血栓预防显示出有限的有意义益处.
结论:
- 治疗性抗凝剂,特别是肝素,在选择的中度病症COVID-19患者中显示出对血栓预防的前景,不需要ICU护理.
- 目前正在进行的试验旨在进一步澄清治疗剂量抗凝剂的作用.
- 目前的证据支持根据最新的指导方针,在特定患者群体中谨慎使用.
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