在范围以下的抗Xa活性与重症COVID-19患者的血栓形成有关
Pilar Marcos-Neira1, Cristian Morales-Indiano2, Mariana Fernández-Caballero3
1Intensive Care Unit, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain.
Medicina intensiva
|July 25, 2024
概括
在严重的COVID-19患者中,抗Xa活性较低显著增加了血栓事件的风险. 监测抗Xa水平可能对有效的抗凝血和预防血栓至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 严重的COVID-19与高血栓事件风险有关.
- 埃诺沙巴林通常用于这些患者的抗凝药.
- 优化抗Xa活性监测对于有效治疗至关重要.
研究的目的:
- 分析严重COVID-19患者的亚治疗性抗Xa活性和血栓事件之间的关系.
- 为了确定这一群体中发生血栓事件的独立风险因素.
主要方法:
- 对228名患有严重COVID-19的ICU患者进行前性观察队列研究.
- 以抗Xa活性测量为指导的埃诺克萨帕林剂量.
- 后勤回归分析以确定血栓事件的风险因素.
主要成果:
- 28.9%的患者出现了新的血栓事件.
- 27.1%的抗Xa测量低于治疗范围.
- 低于范围的抗Xa活性 (RR 4.2),升高的C-反应蛋白和升高的D-二次体是血栓事件的独立预测因素.
结论:
- 亚治疗性抗Xa活性是严重的COVID-19中血栓事件的重要独立风险因素.
- C-反应蛋白和D-二聚物水平也与血栓形成风险相关.
- 需要进一步的临床试验来证实抗Xa监测的好处.
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