在下肢外周动脉疾病患者的抗血栓治疗有静脉血栓栓塞:全国性的队列研究
Jamilla Goedegebuur1,2, Elena Butera3, Qingui Chen2
1Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands.
Research and practice in thrombosis and haemostasis
|January 22, 2026
概括
在患有静脉血栓栓塞事件 (VTE) 的周围动脉疾病 (PAD) 患者中使用抗血栓治疗 (ATT) 是多种多样的. 在静脉瘤治疗期间的管理通常涉及双重治疗,强调需要更明确的指导方针.
科学领域:
- 血管医学 血管医学
- 药理学 药理学是指药理学的学科.
- 临床流行病学 临床流行病学
背景情况:
- 有症状的下肢外周动脉疾病 (PAD) 患者通常需要抗血栓治疗 (ATT).
- 在PAD患者中突破性静脉血栓栓塞事件 (VTE) 的最佳管理策略尚未确定.
- 这项研究调查了VTE患者的PAD患者的ATT处方模式和结果.
研究的目的:
- 在静脉血栓栓塞事件 (VTE) 发生之前,期间和之后,描述患有外围动脉疾病 (PAD) 的患者的抗血栓治疗 (ATT) 处方模式.
- 评估与这些ATT策略相关的临床结果.
- 在这个患者群体中确定VTE管理中异质性的领域.
主要方法:
- 荷兰一项全国性队列研究利用了2013-2021年的报销和药房数据.
- 确定了患有外周动脉疾病 (PAD) 和同时发生静脉血栓栓塞事件 (VTE) 的患者.
- 对抗血栓治疗 (ATT) 处方的分析分为三个时期:VTE前,VTE治疗期间和VTE治疗后.
主要成果:
- 在1866名患有VTE的PAD患者中,ATT的使用在VTE后发生了显著的转变,仅有12%的人接受抗血小板治疗,而在VTE前的患者中,这一比例为64%.
- 直接口服抗凝剂在VTE治疗期间最常见 (40%),其中27%接受双重治疗 (抗凝剂加抗血小板治疗).
- 一年累计发病率为动脉血栓栓塞事件的6.1%,临床相关出血的1.8%.
结论:
- 对于周围动脉疾病 (PAD) 患者的静脉血栓栓塞事件 (VTE) 的抗血栓治疗 (ATT) 管理是异质的.
- 在PAD患者中,很大一部分在VTE治疗期间接受了双重治疗.
- 需要基于证据的共识来指导有关PAD患者VTE的ATT的复杂临床决策.
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