癌症患者的血栓塞栓症:对复发事件的实用指南
Sergey Kozhukhov1,2, Nataliia Dovganych1,2
1Clinical Pharmacology & Cardio-Oncology Department, NSC "The M.D.Strazhesko Institute of Cardiology", 03680 Kyiv, Ukraine.
Reviews in cardiovascular medicine
|December 2, 2024
概括
癌症患者面临高风险的静脉血栓栓塞 (VTE). 本综述详细介绍了癌症患者的复发性VTE (rVTE) 管理方法,探讨了初始抗凝药失败时的风险因素和治疗策略.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 癌症患者患有静脉血栓塞栓症 (VTE) 的风险显著增加,这是该人口中死亡的主要原因.
- 使用低分子量肝素 (LMWH) 或直接口服抗凝剂 (DOAC) 的抗凝疗法是癌症相关血栓瘤 (CAT) 的标准.
- 尽管有效的抗凝药,但癌症患者中仍存在10-20%的静脉突发症复发 (rVTE) 发病率.
研究的目的:
- 审查目前与癌症相关的VTE的管理策略.
- 确定导致癌症患者复发性静脉瘤 (rVTE) 的关键风险因素.
- 概述一种治疗算法,用于管理患有rVTE的患者.
主要方法:
- 关于癌症相关血栓瘤和VTE管理研究的综合文献综述.
- 分析与恶性瘤中VTE复发相关的风险因素.
- 对rVTE的当前治疗选择和指导方针建议的综合.
主要成果:
- 常见的rVTE原因包括不合规,低于最佳的抗凝剂剂量,血小板减少和疾病进展.
- 已确立的CAT管理准则并没有专门针对rVTE.
- 对rVTE的潜在干预措施包括切换到LMWH,剂量升级或下静脉膜过器放置.
结论:
- 在癌症患者中治疗复发性静脉瘤仍然具有挑战性,需要个性化治疗方法.
- 需要进一步的研究来确定在这个高风险人群中对rVTE的最佳治疗策略.
- 本综述为管理复发性VTE癌症患者的临床医生提供了一个框架.
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