选择性色素再吸收抑制剂对凝血的影响:事实还是虚构?
Antoine Mokhtarian1, Sophie Melicine1, Virginie Siguret1,2
1Service d'Hématologie Biologique, Hôpital Lariboisière, APHP.Nord, Paris, France.
Clinical and translational science
|March 19, 2025
概括
选择性血红素再吸收抑制剂 (SSRI) 可能不会显著影响血液凝固. 这项研究没有发现SSRI患者凝血功能受损的证据,尽管已知与出血风险有关.
科学领域:
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
- 临床医学 临床医学
背景情况:
- 选择性血清素再吸收抑制剂 (SSRI) 广泛用于治疗抑郁和焦虑.
- 兴奋剂与增加出血风险有关,主要是由于血小板功能受损.
- 一些证据表明,SSRI也可能直接影响血液凝固.
研究的目的:
- 审查有关SSRI对常规凝血试验影响的现有文献.
- 为了研究citalopram对血栓生成的特定影响.
- 为了确定SSRI是否会影响整体凝血功能.
主要方法:
- 进行了PubMed关于SSRI和凝血试验的22项研究的文献综述.
- 在健康志愿者的血小板贫乏血上进行了血小板生成试验 (TGA).
- 用治疗性 (0.1,0.5μM) 和超治疗性 (50μM) 度的西塔洛普拉姆入血.
主要成果:
- 文献审查显示,关于SSRI对前列血栓时间和激活的部分血栓塑时间的影响的结果不一致.
- 大多数审查的研究发现,SSRI对常规凝血测试没有显著影响.
- 血栓生成试验显示,在italopram暴露时,凝血参数没有显著变化.
结论:
- 目前的证据不支持SSRI对血液凝固试验的显著直接影响.
- 奇塔洛普拉姆在血栓生成试验中没有显示出促凝或抗凝活性.
- 研究结果表明,与SSRI相关的出血风险不太可能是由于凝血直接受损.
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