在骨髓增殖性瘤中治疗状静脉血栓的抗凝药:系统性审查和元分析
Pavlina Chrysafi1, Kevin Barnum2, Genevieve M Gerhard3
1Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts, USA. Electronic address: https://twitter.com/PavlinaChrysafi.
Journal of thrombosis and haemostasis : JTH
|August 10, 2024
概括
患有骨髓增殖性瘤 (MPN) 和静脉血栓症 (SpVT) 的患者在服用抗凝药时面临出血和复发性血栓症的重大风险. 需要进一步的研究来优化这种患者群的治疗策略.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 血管医学 血管医学
背景情况:
- 在肌肉增殖性新生瘤 (MPN) 患有脊柱静脉血栓症 (SpVT) 时,管理抗凝血包括平衡出血和复发性血栓症风险.
- 脊柱静脉血栓症是MPN患者的一种严重并发症.
研究的目的:
- 系统地审查和元分析MPN-SpVT患者出血和血栓复发的发生率.
- 评估与此群体抗凝治疗相关的结果.
主要方法:
- 一个系统的审查和对回顾性或前性研究的元分析.
- 包括的研究至少有10名患有MPN-SpVT的成年患者.
- 评估的结果是复发的静脉和动脉血栓,以及严重出血,汇总率计算在每100个患者年.
主要成果:
- 对参与443名患者的9项研究 (364名抗凝药) 的分析显示,每100名患者年有显著事件发生率:严重出血 (2.8),复发性静脉血栓 (1.4),动脉血栓 (1.4).
- 不接受抗凝药治疗的患者 (79名患者) 的复发静脉血栓 (3.5) 发生率更高,严重出血 (3.2) 和动脉血栓 (1.6) 的发生率相似.
- 对于大多数结果,观察到很高的异质性 (I2>70%).
结论:
- 在MPN-SpVT患者中,抗凝药与严重出血和复发性血栓形成的重大风险有关.
- 对MPN-SpVT的最佳抗凝策略需要进一步调查以改善患者的治疗结果.
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