JAMA:硬膜下血肿的发生率与抗血栓形成药物的使用有关

2017-03-01 MedSci MedSci原创

抗栓药物使用与更高的硬膜下血肿风险相关; 并且VKA和抗血小板药的联合使用发生硬膜下血肿的几率最高。2000年至2015年硬膜下血肿的发病率增加似乎与抗血栓药物的使用增加相关,特别是在老年患者中使用VKA。

硬膜下血肿发生率的变化与抗栓药物使用有关吗?

据报道,硬膜下血肿的发生率正在增加。但是,这与增加使用抗血栓药物的相关性仍然未知的。

近日一项发表在《JAMA》上的观察性研究调查了这个问题。该研究调查了使用抗血栓药物和硬膜下血肿风险之间的关联,并确定一般人群中硬膜下血肿发生率和抗血栓药物使用的趋势。

在这项具有10010个硬膜下血肿病例和400380个对照的观察性研究中,硬膜下血肿风险与抗血栓药物使用显着相关,特别是使用维生素K拮抗剂(调整的优势比,3.69)。 在10010名硬膜下血肿患者中(平均年龄69.2岁; 3462名女性[34.6%]),47.3%的患者服用抗血栓药物。目前使用低剂量阿司匹林(病例:26.7%,对照:22.4%;调整OR,1.24 [95%CI,1.15-1.33]),氯吡格雷(病例:5.0%,对照:2.2% 95%CI,1.57-2.24]),直接口服抗凝剂(病例:1.0%,对照:0.6%;调整的OR,1.73 [95%CI,1.31-2.28])和VKA(病例:14.3% :4.9%;调整OR,3.69 [95%CI,3.38-4.03])与更高的硬膜下血肿风险相关。当与抗血小板药物(低剂量阿司匹林和VKA:3.6%的病例和1.1%的对照;调整的OR,4.00 [95%CI,3.40-4.70)一起使用VKA时,硬膜下血肿的风险最高。抗血栓药物使用的普及率从2000年的每***31.0增加到2015年的每***76.9(趋势P <0.001)。整体硬膜下血肿发生率从2000年的10.9 / 100000人年增加到2015年的19.0 / 100000人年(趋势P <0.001)。老年患者增加最多(> 75岁; n = 4441),经历从55.1每100000人年增加到99.7每100000人年(趋势P <.001)。

因此,硬膜下血肿的发生率与抗血栓形成药物的使用增加相关,特别是使用维生素K拮抗剂的情况下。

原始出处:

David Gaist; Luis Alberto García Rodríguez; Maja Hellfritzsch; et al. Association of Antithrombotic Drug Use With Subdural Hematoma Risk.JAMA. 2017;317(8):836-846. doi:10.1001/jama.2017.0639.

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    2017-04-19 jyzxjiangqin

    硬膜下血肿的发生率与抗血栓形成药物的使用有关。

    0

  4. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Mar 16 07:22:55 CST 2017, time=2017-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1394916, encodeId=5e0013949169d, content=<a href='/topic/show?id=be548989e09' target=_blank style='color:#2F92EE;'>#血肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89897, encryptionId=be548989e09, topicName=血肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=85df2500173, createdName=654699882_84926986, createdTime=Fri Mar 03 00:29:00 CST 2017, time=2017-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419906, encodeId=ec9b141990637, content=<a href='/topic/show?id=3951e36293b' 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    2017-04-08 jyzxjiangqin

    硬膜下血肿的发生率与抗血栓形成药物的使用有关。

    0

  5. 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target=_blank style='color:#2F92EE;'>#硬膜下血肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73629, encryptionId=3951e36293b, topicName=硬膜下血肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b293545002, createdName=lizhou0205, createdTime=Fri Mar 03 00:29:00 CST 2017, time=2017-03-03, status=1, ipAttribution=)]
    2017-03-30 jyzxjiangqin

    硬膜下血肿的发生率与抗血栓形成药物的使用有关。

    0

  6. 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target=_blank style='color:#2F92EE;'>#硬膜下血肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73629, encryptionId=3951e36293b, topicName=硬膜下血肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b293545002, createdName=lizhou0205, createdTime=Fri Mar 03 00:29:00 CST 2017, time=2017-03-03, status=1, ipAttribution=)]
    2017-03-22 jyzxjiangqin

    硬膜下血肿的发生率与抗血栓形成药物的关系。

    0

  7. 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    2017-03-20 jyzxjiangqin

    硬膜下血肿的发生率与抗血栓形成药物的使用。

    0

  8. 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    2017-03-16 jyzxjiangqin

    硬膜下血肿的发生率与抗血栓形成的药物有关。

    0

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