风险评估模型用于预防产后静脉血栓栓塞在患有系统性红斑狼的患者
Myah M Griffin1, Alexis Engel2, Shilpi S Mehta-Lee1
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Langone Health, New York, New York.
American journal of perinatology
|July 26, 2023
概括
系统性红斑狼 (SLE) 患者需要改善产后静脉血栓塞栓症 (VTE) 预防,特别是当不缓解时. 仅仅是SLE诊断并不总是意味着活跃的疾病,对于那些处于缓解期且有其他危险因素的人来说,VTE预防可能是必要的.
科学领域:
- 产科和妇科 产科和妇科
- 类风湿病学 类风湿病学
- 血栓形成研究研究
背景情况:
- 系统性红斑狼 (SLE) 与静脉血栓塞栓症 (VTE) 的风险增加有关,特别是在产后期.
- 有效的VTE风险评估和预防对于治疗SLE的孕妇和产后患者至关重要.
研究的目的:
- 评估皇家妇产科医生学院 (RCOG) 在产后患有SLE的VTE风险模型的适用性.
- 在这个高风险人群中,根据RCOG模型评估VTE预防建议的充分性.
主要方法:
- 从2016年到2022年,对49名患有SLE的女性 (55次怀孕) 的正在进行的患者登记册进行二次分析.
- 使用SLE中缓解的定义 (DORIS) 标准评估SLE疾病活动;RCOG VTE风险评分应用分娩前和分娩后.
- 统计分析包括费舍尔的精确测试,奇平方测试和曼-惠特尼U测试 (p <0.05显著性).
主要成果:
- 61.8%的怀孕在分娩时处于DORIS缓解状态;38.2%没有,在RCOG VTE风险模型上得分≥3.
- 尽管RCOG分数≥3,但只有19%的非缓解妊娠接受了VTE预防建议.
- 即使在缓解后,35.7%的非SLE VTE风险因素 (RCOG评分≥3) 的怀孕也被推进行预防;15%的得分<3也被推.
- 在研究队列中,无论预防措施如何,都没有发生产后VTE事件.
结论:
- 需要加强产后VTE预防SLE患者没有缓解.
- 仅仅是SLE诊断不应该自动将疾病归类为活跃的;缓解状态是关键.
- 如果其他与SLE无关的风险因素存在,产后SLE缓解的患者可能仍然需要VTE预防.
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