[在静脉血栓栓塞并发症的抗凝固剂预防期间出血的实验室预测因素]
A B Agapov1,2, R E Kalinin1, N D Mzhavanadze1
1Ryazan State Medical University named after Academician I.P. Pavlov of the Ministry of Health of the Russian Federation, 390026, Ryazan, Russian Federation.
概括
鉴定服用抗凝剂的高风险出血患者至关重要. 高白细胞和费里水平预测出血并发症,有助于临床风险评估.
科学领域:
- 临床医学 临床医学
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 准确识别患有高出血风险的患者是一个重大的临床挑战,特别突出在COVID-19大流行期间.
- 抗凝剂治疗对于预防静脉血栓栓塞并发症至关重要,但具有固有的出血风险.
研究的目的:
- 评估实验室标记物对接受抗凝剂治疗的患者出血并发症的预测价值.
- 确定与抗凝药期间出血风险相关的关键临床和实验室因素.
主要方法:
- 一项前性观察性研究,涉及370名接受低分子量肝素 (LMWH),未分离肝素 (UFH) 或直接口服抗凝剂 (DOAC) 的患者.
- 评估每个治疗组内的出血并发症发生率和相关实验室参数.
主要成果:
- 肥胖,慢性静脉功能不充分以及有静脉血栓栓塞并发症 (VTEC) 的病史是出血的显著临床预测因素.
- 升高的白细胞和费里水平与抗凝药治疗期间出血风险增加有关.
- 在治疗开始时,高水平的炎症和血栓形成标志物不能预测出血并发症.
结论:
- 高白细胞和费里丁度是抗凝药治疗患者出血风险的重要实验室预测指标.
- 低纤维素和高D-二聚物水平也被确定为潜在的出血风险指标.
- 这些发现可以帮助改进接受抗凝药的患者出血并发症的风险分层模型.
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