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癌症相关静脉血栓栓塞症

Cancer-Associated Venous Thromboembolism.

作者信息

Elewa Hazem, Elrefai Riham, Barnes Geoffrey D

机构信息

College of Pharmacy, Qatar University, PO Box 2713, Doha, Qatar.

Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, 13001 E. 17th Pl., Aurora, CO, 80045, USA.

出版信息

Curr Treat Options Cardiovasc Med. 2016 Apr;18(4):23. doi: 10.1007/s11936-016-0445-y.

Abstract

Cancer patients are at high risk for venous thromboembolism (VTE) which is considered the second leading cause of death among this population. Both cancer and cancer treatment increase this risk. Since the risk of VTE is not the same in all cancer patients, it is important to understand what factors increase the risk of incident and the risk of recurrent VTE in this patient population. In an effort to combine multiple factors into a single risk stratification system, a scoring system for recurrent VTE risk in cancer patients has been developed and externally validated. While vitamin K antagonists (VKA) or the direct oral anticoagulants (DOACs) are first-line therapies for non-cancer-associated VTE treatment, low-molecular-weight heparin (LMWH) agents are the first-line anticoagulant for treatment of cancer-associated VTE. In this review, we discuss the epidemiology, pathophysiology, and risk stratification used in cancer-associated VTE. We also discuss the current therapies for cancer-associated VTE and the evidence supporting their use from the literature.

摘要

癌症患者发生静脉血栓栓塞(VTE)的风险很高,VTE被认为是该人群的第二大死因。癌症本身及癌症治疗都会增加这种风险。由于并非所有癌症患者发生VTE的风险都相同,因此了解哪些因素会增加这一患者群体发生VTE事件及复发的风险很重要。为了将多个因素整合到一个单一的风险分层系统中,已经开发并外部验证了一种癌症患者复发性VTE风险评分系统。虽然维生素K拮抗剂(VKA)或直接口服抗凝剂(DOACs)是非癌症相关VTE治疗的一线疗法,但低分子量肝素(LMWH)制剂是治疗癌症相关VTE的一线抗凝剂。在这篇综述中,我们讨论了癌症相关VTE的流行病学、病理生理学和风险分层。我们还讨论了癌症相关VTE的当前治疗方法以及文献中支持其使用的证据。

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