Bates S M, Ginsberg J S, Straus S E, Rekers H, Sackett D L
Department of Medicine, McMaster University, Hamilton, Ont.
CMAJ. 2000 Oct 17;163(8):1016-21.
The identification of conditions associated with an increased risk of venous thromboembolism may indicate the need for aggressive prophylaxis during periods of high risk, prolonged anticoagulant therapy after an initial venous thromboembolic episode, the investigation of asymptomatic family members and the avoidance of oral contraceptives. Advances in laboratory medicine have led to the identification and assessment of many proteins responsible for normal hemostasis, and associations between abnormalities in a number of these proteins and venous thromboembolism have been reported. Without the ability to appraise this information critically, physicians may be unable to determine whether or how they should modify their clinical practice. Criteria for determining whether specific laboratory abnormalities have a relationship with venous thromboembolism are proposed here, and one example of the application of these guidelines is provided.
识别与静脉血栓栓塞风险增加相关的情况，可能表明在高风险时期需要积极预防、在初次静脉血栓栓塞发作后进行长期抗凝治疗、对无症状家庭成员进行调查以及避免使用口服避孕药。检验医学的进展已促使人们识别和评估了许多负责正常止血的蛋白质，并且已有报告称其中一些蛋白质的异常与静脉血栓栓塞之间存在关联。如果没有能力批判性地评估这些信息，医生可能无法确定他们是否以及应如何改变临床实践。本文提出了确定特定实验室异常与静脉血栓栓塞是否有关的标准，并提供了这些指南应用的一个实例。
