血栓和出血并发症在患有AL氨基粉症的患者中
Despina Fotiou1, Foteini Theodorakakou1, Sotiria Spiliopoulou1
1Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece.
British journal of haematology
|February 7, 2024
概括
粉样粉症患者面临着血栓和出血事件的重大风险. 早期诊断和多参数评估对于管理这些严重并发症至关重要.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 心脏病学 心脏病学
背景情况:
- 血静异常和失调的凝血在AL氨基粉症中很常见.
- 血栓栓塞和出血风险需要在这个患者群体中进行彻底评估.
研究的目的:
- 描述450名AL氨基粉症患者的临床显著的血栓和出血事件.
- 确定这些事件的风险因素和预后变量.
主要方法:
- 450名连续AL粉样化症患者的回顾性分析.
- 平均随访时间为55个月.
- 竞争性风险分析,以评估事件的累积概率.
主要成果:
- 静脉血栓栓塞事件 (VTE) 发生在6%,动脉栓塞事件 (AEE) 发生在5%.
- 在9%的病例中报告了显著出血事件,相关死亡率为19%.
- 以前的血栓形成,较低的白蛋白,较低的eGFR,较高的BM透,软组织参与,IMID治疗与静脉瘤风险有关.
- 冠状动脉疾病,先前的AEE,24小时蛋白尿,高血小板计数与AEE风险相关.
- 肝脏参与,较高的血清肌素,较高的基线VWF:Ag水平与出血风险相关.
结论:
- 在AL粉样化症患者中,血栓/动脉栓塞和出血事件都有显著的风险.
- 诊断后第一年风险最高,但仍然很高.
- 多参数评估对于指导抗血栓或抗血小板治疗至关重要.
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