在aPL消极化后,可以在APS患者中取消抗凝药吗?
Maria J Cuadrado1, Angela Tincani2, Eugenia Enriquez Merayo3
1Clinica Universidad de Navarra, Madrid, Spain.
Autoimmunity reviews
|August 27, 2023
概括
对于患有抗脂综合征 (APS) 的患者,在抗脂抗体 (aPL) 消极化后停止抗凝治疗是有争议的. 本综述审查了关于aPL消极化的证据,以及在APS患者中管理抗凝血的因素.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 用维生素K抗剂 (VKAs) 进行长期抗凝治疗是血栓性抗脂综合征 (APS) 的标准.
- 在APS患者中停止抗凝药的可能性正在讨论中,这些患者获得了抗脂抗体 (aPL) 负化.
- aPL消极化通常被定义为两次负面测试,相隔一年,尽管缺乏共识.
研究的目的:
- 审查有关APS患者aPL消极化现象的现有证据.
- 讨论aPL消极化对APS抗凝剂管理的影响.
- 要突出关键的特征,在决定是否停止抗凝剂在APS患者与负面的aPL测试.
主要方法:
- 对研究的文献综述,研究了血栓性APS患者的aPL消极化.
- 分析与aPL消极化和复发性血栓形成相关的因素.
- 专家意见和指导方针的综合对抗凝血药物管理后aPL消极化.
主要成果:
- 在APS中aPL负化的频率和预测因素是可变的.
- 在aPL消极化后停止抗凝药的安全性和有效性的证据有限且相互矛盾.
- 在aPL阴性APS患者中,复发性血栓形成的风险分层仍然是一个挑战.
结论:
- aPL消极化发生在一些APS患者中,但其对抗凝血管理的临床意义需要进一步调查.
- 停止抗凝药的决定应该是个性化的,考虑患者特定的风险因素和对aPL动态的不断变化的理解.
- 需要进行进一步的研究,以制定明确的指导方针,以优化在患有aPL消极化的APS患者的抗凝策略.
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