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系统性红血性狼患者抗凝的挑战

Luigi Zolio^1,2, Hannah Cohen³, David Isenberg¹

¹Department of Ageing, Rheumatology and Regenerative Medicine, Division of Medicine, University College London, London, UK.

Expert opinion on pharmacotherapy

|April 20, 2025

概括

系统性红斑狼 (SLE) 患者由于高血栓形成风险,往往需要抗凝药. 直接口服抗凝剂 (DOACs) 可能适用于精选的SLE患者,有静脉血栓塞栓症 (VTE).

科学领域:

类风湿病学类风湿病学
心脏病学心脏病学
血液学血液学血液学

背景情况:

系统性红斑狼 (SLE) 患者患心血管疾病和血栓形成的发病率很高.
疾病病理生理学,抗脂综合征 (APS) 重叠,并发症和治疗并发症有助于SLE的血栓形成风险.

研究的目的:

概述心血管疾病和SLE中血栓形成的流行病学和病理生理学,有或没有APS.
讨论与SLE和/或APS相关的心血管并发症和血栓性疾病.
突出目前的抗凝管理指南和疾病特异性考虑,重点关注SLE患者静脉血栓塞栓症 (VTE) 的直接口服抗凝剂 (DOAC).

主要方法:

关于SLE和APS中心血管疾病和血栓形成的当前文献和指导方针的审查.
在SLE中发生的血栓事件的流行病学和病理生理学分析.
讨论抗凝固策略,包括华法林和DOAC,重点关注特定患者群体.

主要成果:

心血管风险评估和抗脂 (aPL) 分析对SLE患者至关重要.
华法林通常是高风险的APS患者的首选药物.
对于选定的SLE/APS患者来说,DOAC是一种可行的选择,患者患有VTE并且没有动脉血栓形成史.

结论:

在SLE中,特别是APS中,抗凝管理需要仔细考虑个体患者的因素.
在灾难性APS (CAPS) 中启动抗凝剂存在重大挑战.
需要进行进一步的研究,以解决尽管服用抗凝血药物,但仍在治疗复发性血栓的知识差距,并优化APS中降低血栓事件的策略.

关键词:

抗凝剂是一种抗凝剂.一个小小的东西.抗脂综合征是一种抗脂综合征.类风湿病学类风湿病学血栓形成的原因是血栓形成.

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