在患有外周动脉疾病的老年患者中,年龄与血栓凝血谱凝血概况的相关性
Adriana A Rodriguez Alvarez1, Isabella Ferlini Cieri1, Katherine L Morrow1
1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA.
Journal of vascular surgery
|February 9, 2025
概括
在控制抗凝血时,年龄不会显著改变老年外周动脉疾病患者的血栓凝血图 (TEG) 凝血概况. TEG可以指导老年人的治疗.
科学领域:
- 血管外科 血管外科
- 血液学 血液学 血液学
- 老年医学 老年医学
背景情况:
- 周围动脉疾病 (PAD) 影响老年人群,需要抗凝管理.
- 血栓形成显微镜 (TEG) 评估凝血,但其在PAD中跨年龄组的实用性尚不清楚.
- 与年龄相关的凝血变化可能会影响PAD治疗结果.
研究的目的:
- 为了研究年龄对PAD的老年患者的血栓凝结谱 (TEG) 凝血概况的影响.
- 为了确定TEG参数是否在接受下肢再血管化的年轻 (65-74岁) 和年长 (75岁以上) 的老年患者之间有所不同.
- 测试假设TEG参数在控制抗凝血方案时在不同年龄组保持一致的假设.
主要方法:
- 这是一项对158名患者 (≥65岁) 的前性观察性研究,这些患者正在接受PAD的下肢再血管化.
- 患者按年龄分层 (65-74岁与75岁以上) 和抗凝血状态 (单抗血小板,双抗血小板,治疗性抗凝血,没有).
- 使用ANOVA和千平方/费舍尔精确测试,分析和比较年龄和抗凝血组之间的手术前TEG凝血概况.
主要成果:
- 通过抗凝血疗法分层的年龄组之间没有观察到TEG参数 (反应时间,最大幅度,溶解,角度,ADP聚合/抑制) 的显著差异 (所有P > .05).
- 在65-74岁和75岁以上的年龄组中,血栓形成率与65-74岁和75岁以上的年龄组相似 (21.1%对20.6%;P = .936).
- 在75岁以上的年龄组,死亡率明显高于65-74岁的年龄组 (20.6%对5.6%;P = .005).
结论:
- 通过TEG测量的客观凝血参数在老年PAD患者中与年龄没有显著差异,当抗凝血药物标准化时.
- 泰格 (TEG) 档案显示出在老年PAD人群中引导抗凝管理的潜力.
- 需要进一步的研究,以充分理解TEG在PAD老年患者凝血监测中的作用.
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