公共卫生 公共卫生
Zafarullah M Chaudhary1,2, Tovia Jacobs1, Matin Soeizi1,2
1NYU Grossman School of Medicine, New York, NY, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
概括
相当数量的阿尔茨海默病患者使用抗凝剂,主要用于心房动. 这凸显了对个性化治疗方案和扩展临床试验的需求,以确保安全获得新的阿尔茨海默氏症疗法.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿尔茨海默氏症 (AD) 影响超过600万美国人,构成重大公共卫生挑战.
- 针对AD治疗的新型抗粉样蛋白单克隆抗体引发了关于粉样蛋白相关脑成像异常 (ARIA) 的安全担忧,特别是在接受抗凝药的患者中.
- 在老年人中,心房 (AFib) 很普遍,抗凝血是标准的中风预防方法,这可能与阿尔茨海默病治疗资格产生冲突.
研究的目的:
- 确定在被诊断患有轻度认知障碍 (MCI) 和轻度痴呆阶段的阿尔茨海默病 (AD) 患者中使用抗凝剂的流行率.
- 在这个患者群体中评估抗凝血药物,特别是心脏动 (AFib) 的适用性.
- 为治疗方案和未来的AD疗法临床试验设计提供信息.
主要方法:
- 从国家阿尔茨海默氏症协调中心 (NACC) 数据库的数据的回顾性审查.
- 纳入标准:在MCI或轻度痴呆阶段的AD临床诊断,最小精神状态检查 (MMSE) 分数为20或以上.
- 使用统计方法 (皮尔森的千平方,t测试,ANOVA) 分析抗凝剂的使用,说明和与人口统计和神经病理学数据的相关性.
主要成果:
- 在10,586名患有AD (MCI或轻度痴呆症) 的个人中,6.9%接受了抗凝剂治疗.
- 抗凝剂使用者年龄较大,更有可能是男性和白人,AFib率显著更高 (53.0%对3.2%).
- 华法林是最常见的抗凝药,8.56%的确诊AD神经病理变化的个体正在服用抗凝药.
结论:
- 很大一部分患有阿尔茨海默病的人正在接受抗凝治疗,主要是针对AFib.
- 目前针对抗凝血药患者的AD治疗排除标准限制了对潜在有益疗法的获取.
- 需要个性化AFib治疗方法,早期AD检测和未来AD临床试验,以安全地包括抗凝血患者.
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