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在1381名患有本质性血栓细胞血症的患者中预测重大出血事件
Ruth Stuckey1, Jean-Christophe Ianotto2, Marco Santoro3
1Hematology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain.
International journal of hematology
|September 3, 2023
概括
抗凝血药物等基本血栓塞血症 (ET) 治疗增加了严重出血的风险. 出血,而不是血栓形成,显著影响存活率,需要更好地评估ET患者的出血风险.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床医学 临床医学
背景情况:
- 基本血小板血 (ET) 管理旨在预防血小板事件.
- 目前的风险分层模型不能充分预测大出血 (MB).
- 常见的ET疗法对出血风险的影响还不清楚.
研究的目的:
- 评估抗血小板,细胞减小和抗凝疗对基本血小板血 (ET) 严重出血 (MB) 风险的影响.
- 为了确定ET患者大出血的危险因素.
- 评估ET中出血,血栓形成和生存之间的关联.
主要方法:
- 来自10个欧洲中心的1381名ET患者的回顾性分析.
- 评估主要出血 (MB) 事件及其与各种疗法的相关性.
- 统计分析包括危险比率 (HR) 和几率比率 (OR) 以评估风险因素和生存关联.
主要成果:
- 严重出血 (MB) 的发生率为0.286事件/人/年.
- 年龄和白细胞计数被确定为MB风险因素;低血红蛋白具有保护作用.
- 抗凝药,特别是维生素K对抗剂,显著增加了MB风险 (HR 3.05).
- 细胞减少在ET中没有保护性作用,具有极端的血栓细胞和白细胞.
- 出血,而不是血栓形成,与10年生存率显著相关 (OR 2.54).
结论:
- 现有的预后得分 (IPSET-t,r-IPSET-t) 不能预测无出血的生存率.
- 抗凝治疗是ET大出血的重要危险因素.
- 在ET患者中,出血比血栓形成更大的死亡风险.
- 改善MB的风险分层和仔细考虑治疗选择对于ET管理至关重要.
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