Meijer Karina, Schulman Sam
Thrombosis Service, McMaster Clinic, HHS-General Hospital, Hamilton, Ontario, Canada.
Semin Thromb Hemost. 2008 Nov;34(8):762-71. doi: 10.1055/s-0029-1145258. Epub 2009 Feb 12.
The risk of bleeding associated with antithrombotic and fibrinolytic therapy depends on factors that are specific for the drugs and the patients. In this narrative review, we describe the most important risk factors for bleeding for each class of drugs. Pertinent examples are recent initiation of therapy with vitamin K antagonists, low-molecular-weight heparins, and renal dysfunction, and higher dose of aspirin. However, for every class of drug, there are also examples that are more controversial. Knowledge of these risk factors helps to weigh the risk and benefit in the selection of therapy in individual patients. Moreover, some risk factors can be modified or avoided if they are recognized.
抗血栓形成和纤维蛋白溶解疗法相关的出血风险取决于药物和患者的特定因素。在这篇叙述性综述中，我们描述了每类药物最重要的出血危险因素。相关例子包括近期开始使用维生素K拮抗剂、低分子量肝素治疗以及肾功能不全，还有高剂量阿司匹林。然而，对于每类药物，也存在一些更具争议性的例子。了解这些危险因素有助于在为个体患者选择治疗方法时权衡风险和益处。此外，如果能够识别某些危险因素，就可以对其进行调整或避免。
