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成人癌症患者低分子量肝素的抗Xa监测

Anti-Xa monitoring of low-molecular-weight heparin in adult patients with cancer.

作者信息

Kreuziger Lisa Baumann, Streiff Michael

机构信息

BloodCenter of Wisconsin, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, and.

Department of Medicine, Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, MD.

出版信息

Hematology Am Soc Hematol Educ Program. 2016 Dec 2;2016(1):206-207. doi: 10.1182/asheducation-2016.1.206.

DOI:10.1182/asheducation-2016.1.206
PMID:27913481
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6142453/
Abstract

A 68-year-old man developed a right femoral vein deep vein thrombosis and bilateral pulmonary embolism while receiving chemotherapy for stage IV prostate cancer. His creatinine at diagnosis is 1.4 mg/dL, with an estimated clearance of 63 mL/min. In patients with cancer, should low-molecular-weight heparin treatment be dosed according to weight, or adjusted using anti-Xa levels?

摘要

一名68岁男性在接受IV期前列腺癌化疗时发生右股静脉深静脉血栓形成和双侧肺栓塞。他诊断时的肌酐为1.4mg/dL，估计清除率为63mL/min。对于癌症患者，低分子量肝素治疗应根据体重给药，还是使用抗Xa水平进行调整？

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Anti-Xa monitoring of low-molecular-weight heparin in adult patients with cancer.成人癌症患者低分子量肝素的抗Xa监测
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Effect of patient weight on the anticoagulant response to adjusted therapeutic dosage of low-molecular- weight heparin for the treatment of venous thromboembolism.患者体重对调整治疗剂量的低分子肝素治疗静脉血栓栓塞症抗凝反应的影响。
Haemostasis. 2001 Jan-Feb;31(1):42-8. doi: 10.1159/000048043.
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Pneumonol Alergol Pol. 2002;70(3-4):203-9.
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[Not Available].[无可用内容]。
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[Treatment and prophylaxis of deep venous thrombosis with low molecular weight heparins (meta-analysis of clinical trials)].[低分子量肝素治疗和预防深静脉血栓形成（临床试验的荟萃分析）]
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A fixed-dose combination of low molecular weight heparin with dihydroergotamine versus adjusted-dose unfractionated heparin in the prevention of deep-vein thrombosis after total hip replacement.低分子量肝素与双氢麦角胺固定剂量组合对比调整剂量普通肝素预防全髋关节置换术后深静脉血栓形成的研究
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Cancer-Associated Thrombosis: Beyond Clinical Practice Guidelines-A Multidisciplinary (SEMI-SEOM-SETH) Expert Consensus.癌症相关血栓形成：超越临床实践指南——多学科（SEMI-SEOM-SETH）专家共识
TH Open. 2018 Nov 5;2(4):e373-e386. doi: 10.1055/s-0038-1675577. eCollection 2018 Oct.

本文引用的文献

1
Clinical Use of Anti-Xa Monitoring in Malignancy-Associated Thrombosis.抗Xa监测在恶性肿瘤相关性血栓形成中的临床应用
Thrombosis. 2015;2015:126975. doi: 10.1155/2015/126975. Epub 2015 Oct 12.
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Tinzaparin vs Warfarin for Treatment of Acute Venous Thromboembolism in Patients With Active Cancer: A Randomized Clinical Trial.替扎肝素与华法林治疗活动性癌症患者急性静脉血栓栓塞症的随机临床试验。
JAMA. 2015 Aug 18;314(7):677-686. doi: 10.1001/jama.2015.9243.
3
Achievement of therapeutic anti-Xa levels in a proven heparin-resistant patient through the use of nontraditional high-dose enoxaparin.通过使用非传统高剂量依诺肝素，在一名已证实肝素抵抗的患者中实现治疗性抗Xa水平。
Ann Pharmacother. 2015 Jan;49(1):130-4. doi: 10.1177/1060028014554649. Epub 2014 Oct 6.
4
Antithrombotic therapy in neonates and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.新生儿和儿童的抗血栓治疗：抗血栓治疗和血栓预防，第 9 版：美国胸科医师学会基于证据的临床实践指南。
Chest. 2012 Feb;141(2 Suppl):e737S-e801S. doi: 10.1378/chest.11-2308.
5
Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.静脉血栓栓塞症的抗血栓治疗：《抗血栓治疗与血栓预防，第 9 版》：美国胸科医师学会循证临床实践指南。
Chest. 2012 Feb;141(2 Suppl):e419S-e496S. doi: 10.1378/chest.11-2301.
6
Low-molecular-weight heparins in renal impairment and obesity: available evidence and clinical practice recommendations across medical and surgical settings.肾功能损害和肥胖患者中的低分子量肝素：医疗和外科环境中的现有证据及临床实践建议
Ann Pharmacother. 2009 Jun;43(6):1064-83. doi: 10.1345/aph.1L194. Epub 2009 May 19.
7
Management of refractory venous thrombosis associated with malignancy using a supra-therapeutic enoxaparin regimen.采用超治疗剂量依诺肝素方案治疗与恶性肿瘤相关的难治性静脉血栓。
Ir J Med Sci. 2009 Sep;178(3):339-41. doi: 10.1007/s11845-008-0200-9. Epub 2008 Aug 27.
8
Meta-analysis: low-molecular-weight heparin and bleeding in patients with severe renal insufficiency.荟萃分析：低分子量肝素与严重肾功能不全患者的出血情况
Ann Intern Med. 2006 May 2;144(9):673-84. doi: 10.7326/0003-4819-144-9-200605020-00011.
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Extended enoxaparin monotherapy for acute symptomatic pulmonary embolism.依诺肝素延长单药治疗急性症状性肺栓塞
Vasc Med. 2005 Nov;10(4):251-6. doi: 10.1191/1358863x05vm634oa.
10
Anti-Xa effect of a low molecular weight heparin (dalteparin) does not accumulate in extended duration therapy for venous thromboembolism in cancer patients.低分子量肝素（达肝素）的抗Xa因子作用在癌症患者静脉血栓栓塞症的延长疗程治疗中不会蓄积。
Thromb Haemost. 2005 Jun;93(6):1185-8. doi: 10.1160/TH05-01-0052.