基于肝素的抗凝药在患有和没有高输出胆胸部的患者中的比较:试点研究
Angela Chen1, Livia Linden2, Li Lin3
1Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. aychen98@gmail.com.
Pediatric cardiology
|November 22, 2025
概括
在心脏手术后患有胆胸外科的儿童可能会因为抗血素 (AT) 损失而经历未分离肝素 (UFH) 和低分子量肝素 (LMWH) 的有效性降低. 需要进一步的研究来证实这些发现.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 血液学 血液学 血液学
- 胸部外科手术 胸部外科手术
背景情况:
- 胸是儿科患者心脏手术后的一种并发症.
- 在这些患者中,可能会出现抗血素 (AT) 缺乏,这可能会影响抗凝剂的有效性.
- 了解基洛托拉克斯对抗凝血的影响对于患者管理至关重要.
研究的目的:
- 为了研究高输出胆胸对未分离的氨酸 (UFH) 和氨酸在心脏手术后的儿科患者的治疗疗效的影响.
- 为了比较抗凝剂的效果和不良事件,在有或没有高输出胆胸部的患者.
主要方法:
- 追溯试点研究,包括儿童患者 (0-18岁) 接受UFH或ENOXAPARIN治疗.
- 根据年龄和抗凝剂持续时间,与对照患者匹配高输出胆胸病例 1:2.
- 比较治疗性抗Xa水平,剂量调整,AT水平和不良事件 (血栓,出血).
主要成果:
- 在前七天 (p=0.06) 中,高输出胆胸与UFH的数值较低的治疗抗Xa水平有关.
- 胆胸病患者需要更多地调整UFH和埃诺沙巴林的剂量,以达到治疗水平.
- 对于这两种抗凝剂,在胆胸组中观察到较低的基线和最小的AT水平,在血栓形成或出血方面没有显著差异.
结论:
- 高输出胆胸部可能会损害心脏手术后儿童患者UFH的治疗效果.
- 对埃诺沙巴林疗效的影响不太清楚,尽管发现了更高的剂量和更多的调整.
- 需要进行更大规模的研究,以确定基洛托拉克斯对血静结局和抗凝药治疗的影响.
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