艾皮克萨班与维生素K对抗剂与血栓后综合征相关;来自前性队列研究的数据
Annisa Aarts1, Lloyd Brandts2, Marieke Pavlicic3
1Thrombosis Expertise Center, Heart+Vascular Center, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.
Journal of thrombosis and haemostasis : JTH
|December 24, 2025
概括
在深静脉血栓症 (DVT) 患者中使用阿皮克萨班与血栓后综合征 (PTS) 的风险和严重程度降低有关. 这种益处在接受抗凝治疗的肥胖个体中尤为明显.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 血栓后综合征 (PTS) 是深静脉血栓症 (DVT) 后的一个常见并发症.
- 由于安全性和有效性,直接口服抗凝剂 (DOACs) 优先于维生素K对抗剂 (VKAs) 治疗内脏静脉瘤.
- 之前的研究表明,与VKA相比,里瓦洛克萨班可能会降低PTS风险.
研究的目的:
- 为了比较PTS的发病率在DVT患者治疗阿皮克萨班与VKAs.
- 评估阿皮克萨班对PTS严重性的影响.
主要方法:
- 一项前性队列研究分析了2003年至2022年的成年DVT患者.
- 治疗指南在2017年从VKAs转向阿皮克萨班.
- 多变量逻辑回归评估了apixaban/VKA使用和PTS之间的关联,定义为DVT后6个月Villalta得分≥5的PTS.
主要成果:
- 在阿皮克萨班患者中,PTS发生在28.0%的患者中,而在VKA患者中,PTS发生在35.7%.
- 使用阿皮克萨班与PTS的几率明显降低 (调整后OR为0.62).
- 中度至重度的PTS在阿皮克萨班治疗中较少发生 (调整后OR为0.42),特别是在肥胖患者中 (调整后OR为0.44).
结论:
- 艾皮克萨班与DVT后PTS的风险和严重程度降低有关.
- 阿皮克萨班对PTS的保护作用在肥胖个体中更为明显.
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