在COVID-19治疗中使用抗凝剂的分步剂量
Minh-Hoang Tran1, Hoang Hai Nguyen2, Quang Trung Nguyen2
1Therapeutics, NTT Hi-Tech Institute, Nguyen Tat Thanh University, Ho Chi Minh City, VNM.
Cureus
|September 20, 2024
概括
在COVID-19患者中基于步骤的抗凝剂剂量显示,增加剂量 (预防性至治疗性) 减少了不良事件. 然而,单独使用治疗性抗凝剂会增加出血风险,这凸显了定制抗凝剂策略的重要性.
科学领域:
- 内部医学 内部医学
- 药理学 药理学是指药理学的学科.
- 临界护理医学 临界护理医学
背景情况:
- 基于步骤的抗凝剂剂量适用于COVID-19,但缺乏全面的有效性和安全性数据.
- 之前的研究还没有完全评估基于标准预防剂量的逐步抗凝剂策略.
研究的目的:
- 为了比较基于阶段的抗凝剂剂量与住院COVID-19患者的标准预防剂量的临床结果.
- 评估不同抗凝剂剂量策略在COVID-19中的有效性和安全性.
主要方法:
- 对住院患有中度至重度COVID-19的成年人进行了回顾性队列研究.
- 分类抗凝剂方案:预防性 (PrA),预防性到治疗性 (Pr-to-ThA),治疗性 (ThA) 和治疗性到预防性 (Th-to-PrA).
- 主要结局包括死亡率,ICU入院,中风,VTE (有效性) 和出血事件 (安全性) 的复合.
主要成果:
- 与标准预防性抗凝剂 (PrA) (aOR 0.64) 相比,预防性到治疗性 (Pr-to-ThA) 组显示不良疗效结果的风险明显较低.
- 治疗性抗凝剂 (ThA) 和治疗性到预防性 (Th-to-PrA) 剂量与出血事件的风险增加有关 (aOR分别为3.05和3.00).
- 与PrA相比,Pr-to-ThA组没有观察到出血风险的显著增加.
结论:
- 基于步骤的抗凝剂治疗,特别是从预防剂量增加到治疗剂量,与COVID-19患者的复合不良结果减少有关.
- 标准治疗性抗凝剂 (ThA) 剂量增加出血风险,主要是轻微和临床相关的非重大出血.
- 剂量升级策略可能在住院COVID-19患者中提供一种有利的疗效和安全平衡,需要进一步调查.
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