在接受化疗的女性癌症患者中,使用血小板造影和Khorana评分评估高凝血性和VTE风险
Yousra Tera1,2, Yoon Jin Suh3, Karina Fainchtein1
1Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada.
American journal of hematology
|March 1, 2024
概括
化疗会增加患有癌症的女性血栓的风险. 血栓形成显微镜 (TEG) 显示高凝血性,可能改善静脉血栓塞栓症 (VTE) 风险评估超出Khorana评分 (KS).
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 静脉血栓栓塞 (VTE) 是接受化疗的癌症患者的重大并发症.
- 现有的风险评估模型,如Khorana得分 (KS),在预测女性癌症中的VTE方面存在局限性.
- 众所周知,化疗方案会加剧血栓形成的风险.
研究的目的:
- 评价用于评估化学治疗的癌症妇女的凝血概况的血栓形成显微镜 (TEG).
- 为了确定TEG参数是否可以提高VTE风险分层,超出Khorana得分.
- 在这个患者队列中调查TEG发现和VTE发展之间的相关性.
主要方法:
- 招募36名计划接受化疗的女性癌症患者 (乳腺,子宫内膜,卵巢).
- 对人口统计,癌症细节,BMI,Khorana分数 (KS) 和VTE风险因素的基线评估.
- 在基线和化疗后循环中对凝血概况进行血栓形成显微镜 (TEG) 分析.
- 预期6个月的随访记录血栓事件.
主要成果:
- 在循环1后的63%和循环2后的75%检测到高凝血率,其最大幅度 (MA) 和凝血指数 (CI) 的增加,以及反应时间 (R),凝血动力学 (K) 和溶解时间 (LY30) 的减少.
- 霍拉纳评分 (KS) 将7%的高风险,23%的低风险和70%的中等风险归类为高风险.
- 增加的MA和CI与中等和高风险的KS类别相关,并且与KS相对正相关.
- 五名患者发生了静脉瘤;所有测试患者都表现出高凝血能力,80%的患者患有中等风险的KS.
结论:
- 血栓形成显微镜 (TEG) 有效地识别了接受化疗的癌症患者的高凝血能力.
- TEG参数,特别是MA和CI,显示出对VTE风险评估的潜在标记.
- 在女性癌症患者中,TEG可以作为Khorana得分的辅助来改善VTE风险预测,因此需要进行更大的研究.
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