在管道栓塞后使用标签上的clopidogrel剂量使用clopidogrel过敏反应和出血并发症
Paige Morgan Nickelsen1, Ron Neyens2,3, Sami Al Kasab4,5
1Department of Pharmacy, University of California San Diego Health, San Diego, CA, USA.
Journal of pharmacy practice
|August 12, 2024
概括
这项研究发现,在神经内血管手术后,克洛皮多格雷尔过敏反应患者的出血并发症较少. 大多数出血发生在正常反应的患者中,特别是在手术期间或手术后不久.
科学领域:
- 神经内血管外科 神经内血管外科
- 药理学 药理学是指药理学的学科.
- 临床结果 临床结果
背景情况:
- 克洛皮多格勒的高反应性与神经内血管手术后的出血风险有关.
- 为了最大限度地减少并发症,最佳的克洛皮多格雷尔剂量和时间仍在调查中.
- 流动转移手术后,出血并发症是一个重大问题.
研究的目的:
- 在管道栓塞装置 (PED) 放置后,调查与标准克洛皮多格勒剂量相关的出血并发症.
- 为了比较克洛皮多格勒过度响应和正常响应患者之间的出血率.
- 为了确定出血并发症的时间,与神经内血管程序有关.
主要方法:
- 对148名接受PED流转的成年患者进行了回顾性队列研究.
- 根据使用VerifyNow P2Y12反应单位 (PRU) 的克洛皮多格雷尔反应来对患者进行分类.
- 超响应 (PRU ≤70) 和正常响应 (PRU 71-194) 组在出血并发症方面进行了比较.
主要成果:
- 36.5%的患者对克洛皮多格雷尔有过度反应 (PRU ≤70).
- 在高反应组中没有发生出血并发症;在正常反应组中发生了5例 (P=0.09).
- 内出血是最常见的 (60%),发生在程序内或第一周内. 年龄>60是一个预测因素 (P=0.004).
结论:
- 这些发现与先前的文献相矛盾,显示克洛皮多格雷尔超响应患者的出血并发症较少.
- 出血并发症主要发生在急性术前期.
- 60岁以上的年龄是PED安置后出血并发症的重要危险因素.
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