在肥胖患者的表面静脉血栓形成
Lucía Ordieres-Ortega1,2,3, Rubén Alonso-Beato1,2,3, Tatiana Pire-García1
1Venous Thromboembolism Unit, Internal Medicine Department, General University Hospital Gregorio Marañón, 28007 Madrid, Spain.
Journal of clinical medicine
|July 29, 2025
概括
肥胖不会增加静脉血栓塞栓症 (VTE) 在患有表面静脉血栓症 (SVT) 的患者中复发的风险. 标准抗凝药似乎对患有SVT的肥胖个体安全有效.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 血液学 血液学 血液学
背景情况:
- 对于患有表面静脉血栓症 (SVT) 的肥胖患者来说,最佳的抗凝剂还没有得到很好的定义.
- 肥胖对抗凝血模式和下肢SVT的结果的影响需要进一步调查.
研究的目的:
- 为了评估肥胖对抗凝血策略和诊断下肢SVT的患者的临床结果的影响.
- 为了比较静脉血栓塞栓症 (VTE) 复发,严重出血和肥胖和非肥胖SVT患者之间的死亡率.
主要方法:
- 对136名下肢SVT患者进行的前性观察研究 (≥5厘米长,≥3厘米距离saphenofemoral接口).
- 被归类为肥胖 (BMI ≥ 30) 或非肥胖 (BMI < 30) 的患者,并被跟踪一年.
- 主要结局:VTE复发 (SVT,DVT,PE);次要结局:严重出血,所有原因的死亡率.
主要成果:
- 58%的患者肥胖;肥胖患者年轻,吸烟率更高.
- 91.9%的患者接受了抗凝药,主要是LMWH或 fondaparinux的预防剂量.
- 两组之间在90天或365天的VTE复发 (p=0.505) 或重大出血方面没有发现显著差异. 女性性别与更高的静脉瘤复发率有关 (OR 4.33,p=0.028).
结论:
- 肥胖与下肢SVT患者的VTE复发增加无关.
- 标准抗凝疗方案似乎适用于患有SVT的肥胖患者.
- 需要进一步的研究来证实这些发现,并优化肥胖人口中SVT管理.
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