stroke:疫苗诱发的免疫性血栓性血小板减少症导致的脑静脉血栓结局

2022-09-10 MedSci原创 MedSci原创

疫苗引起的免疫性血栓性血小板减少症(VITT)导致的脑静脉血栓(CVT)是一种严重的疾病,院内死亡率很高。

疫苗引起的免疫血栓性血小板减少症(VITT)导致的脑静脉血栓(CVT)是一种严重的疾病,院内死亡率很高。在此,来自荷兰阿姆斯特丹大学的学者报告了SARS-CoV-2疫苗接种后CVT-VITT患者的临床结果,结果发表在Stroke杂志上。

研究人员使用了一个国际登记处的数据,该登记处收集了截至2022年2月10日的SARS-CoV-2疫苗接种后28天内发生CVT的患者。VITT诊断是根据Pavord标准分类的。结果是死亡率、功能独立(mRS量表评分0-2)、VITT复发、新的血栓形成和出血事件(均在初次住院出院后)。

结果显示,在107例CVT-VITT病例中,43例(40%)在初次住院期间死亡。在其余64名患者中,有60名(94%)患者(37名明确的VITT,9名可能的VITT,14名可能的VITT)的随访数据。中位年龄为40岁,45/60(75%)患者为女性。随访时间中位数为150天(四分位数范围,94-194)。两名患者在随访期间死亡(3%[95%CI,1%-11%])。53/60(88% [95% CI, 78%-94%])患者实现了功能独立。没有新的静脉或动脉血栓事件的报告。一名患者在随访期间发生了大出血(致命的脑内出血)。

综上,与CVT-VITT在急性期的高死亡率相比,在初次住院时存活下来的患者的死亡率很低,没有发生新的血栓事件,出血事件也很罕见。在急性期存活的10名CVT-VITT患者中,约有9人在随访时功能独立。

参考文献:

Outcomes of Cerebral Venous Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia After the Acute Phase.

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    2023-02-17 fusion
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    2023-04-25 ms2000001748789961 来自广东省

    什么药物

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    2023-03-26 xue8602
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