在患有胃肠道出血的患者中,DOACs的血药物值:一项前性观察性研究
Dorotea Bozic1, Damir Alicic1, Dinko Martinovic2
1Department of Gastroenterology, Clinic for Internal Medicine, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia.
Medicina (Kaunas, Lithuania)
|August 26, 2023
概括
超过三分之一的直接口服抗凝剂 (DOAC) 患有胃肠道出血 (GIB) 的患者的药物水平过高,特别是那些服用达比加特兰的患者. 年龄和功能是DOAC度升高的关键因素.
科学领域:
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
- 临床医学 临床医学
背景情况:
- 直接口服抗凝剂 (DOAC) 广泛用于血栓栓塞的预防.
- 胃肠道出血 (GIB) 是与抗凝药治疗相关的已知并发症.
- 了解GIB患者的药物度对于患者的安全至关重要.
研究的目的:
- 为了确定高血药物度在用DOACs治疗的GIB患者中的患病率.
- 为了确定与过度药物水平相关的临床特征.
- 为了比较不同DOAC (阿皮克萨班,里瓦罗克萨班,达比加特兰) 的药物度.
主要方法:
- 在2020年2月至2022年3月期间接受GIB治疗的90名患者的前性研究.
- 根据处方的DOAC (阿皮克萨班,里瓦罗克萨班,达比加特兰) 来对患者进行分类.
- 血中药物度的测量和与文献报告的Cmax和Ctrough值进行比较.
主要成果:
- 37.8%的患者的Cmax高于切断值,31.1%的患者的Ctrough高于切断值.
- 达比加特兰组显示出高度的患病率最高 (Cmax为55.6%,Ctrough为59.3%).
- 高龄和球过率受损是药物水平过高的重要预测因素.
结论:
- 在GIB患者中,血DOAC度升高是常见的,特别是与达比加.
- 临床医生在给老年患者或患有功能障碍的患者开大比加特兰时应谨慎行事.
- 在高风险患者中考虑剂量调整,治疗药物监测或切换DOAC.
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