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Leuk Lymphoma：恶性血液肿瘤患者重度血小板减少 发生VTE要不要抗凝？

2017-08-15 梁舒瑶 环球医学资讯

恶性血液肿瘤患者重度血小板减少抗凝
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2017年11月，发表在《Leuk Lymphoma》的一项由美国科学家进行的回顾性队列研究，分析了恶性血液肿瘤患者重度血小板减少期间，治疗静脉血栓栓塞（VTE）的抗凝策略。

2017年11月，发表在《Leuk Lymphoma》的一项由美国科学家进行的回顾性队列研究，分析了恶性血液肿瘤患者重度血小板减少期间，治疗静脉血栓栓塞（VTE）的抗凝策略。

在重度血小板减少时，使用抗凝治疗VTE的安全性和有效性不清楚。在本项回顾性研究中，研究人员评估了恶性血液肿瘤患者和抗凝前血小板计数＜50×109/L的急性或慢性VTE患者，或当血小板＜50×109/L时发生急性VTE的患者。在78名符合条件的患者中，通过管理策略比较了100天内复发性VTE或临床上显着出血的时间的首要结局。出血发生在27%接受抗凝治疗的患者中，而未抗凝的患者中发生率为3%（RR 10.1，95% CI，1.5~432.6）。复发性VTE出现在2%接受抗凝治疗的患者中，而未抗凝的患者中发生率为15%（IRR 0.17，95% CI，0.0~1.51）。大多数出血发生在前31天（11/13），但复发性VTE大多发生在40天后（5/6）。研究结果表明，恶性血液肿瘤患者在重度血小板减少期间，暂时不进行VTE的抗凝治疗可能会减少不良结局。

原始出处：
Houghton DE, Key NS, Zakai NA, et al.Analysis of anticoagulation strategies for venous thromboembolism during severe thrombocytopenia in patients with hematologic malignancies: a retrospective cohort.Leuk Lymphoma. 2017 Nov;58(11):2573-2581. doi: 10.1080/10428194.2017.1306644. Epub 2017 Apr 9.

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    2018-05-27 ms5187542471278033

    #lymphoma#

    0

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    2017-12-18 bbwuyu_003

    #恶性血液肿瘤#

    0

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    2017-08-17 柳叶一刀

    #血小板减少#

    0

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    2017-08-17 lanyan20020087

    #肿瘤患者#

    0

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    2017-08-15 1e145228m78(暂无匿称)

    学习了，谢谢作者分享!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1689297, encodeId=06e2168929e46, content=<a href='/topic/show?id=1ddd11158fb' target=_blank style='color:#2F92EE;'>#lymphoma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11158, encryptionId=1ddd11158fb, topicName=lymphoma)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=45ae28785510, createdName=ms5187542471278033, createdTime=Sun May 27 19:05:00 CST 2018, time=2018-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1934484, encodeId=e0dc1934484ed, content=<a href='/topic/show?id=7aec5295606' target=_blank style='color:#2F92EE;'>#恶性血液肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52956, encryptionId=7aec5295606, topicName=恶性血液肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60b4474, createdName=bbwuyu_003, createdTime=Mon Dec 18 14:05:00 CST 2017, time=2017-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302765, encodeId=3ea91302e6511, content=<a href='/topic/show?id=9c72890153c' target=_blank style='color:#2F92EE;'>#血小板减少#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89015, encryptionId=9c72890153c, topicName=血小板减少)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Thu Aug 17 07:05:00 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1424196, encodeId=3be914241966e, content=<a href='/topic/show?id=94c182929d0' target=_blank style='color:#2F92EE;'>#肿瘤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82929, encryptionId=94c182929d0, topicName=肿瘤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60943920553, createdName=lanyan20020087, createdTime=Thu Aug 17 07:05:00 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233913, encodeId=85e82339131d, content=学习了，谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Tue Aug 15 23:12:19 CST 2017, time=2017-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233847, encodeId=0a7823384e15, content=恶性血液肿瘤患者在重度血小板减少期间，暂时不进行VTE的抗凝治疗可能会减少不良结局。, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Tue Aug 15 19:34:24 CST 2017, time=2017-08-15, status=1, ipAttribution=)]
    2017-08-15 随梦飞扬

    恶性血液肿瘤患者在重度血小板减少期间，暂时不进行VTE的抗凝治疗可能会减少不良结局。

    0