高凝状态与易栓症：与复发性静脉血栓栓塞相关的风险
Hypercoagulable States and Thrombophilias: Risks Relating to Recurrent Venous Thromboembolism.
作者信息
Rybstein Marissa D, DeSancho Maria T
机构信息
Division of Hematology-Oncology, Department of Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, New York, New York.
出版信息
Semin Intervent Radiol. 2018 Jun;35(2):99-104. doi: 10.1055/s-0038-1642037. Epub 2018 Jun 4.
Abstract
Inherited and acquired thrombophilias and hypercoagulable states, such as active cancer, estrogen-induced, autoimmune disorders, major surgery, hospitalization, and trauma, are well-known risk factors for venous thromboembolism (VTE). The effect of these on recurrent VTE is different for each specific risk factor. The major risk factors affecting VTE recurrence include the presence of active cancer and an unprovoked first VTE. In addition, the use of combined female hormones in a woman with a previous history of estrogen-related VTE is a major risk factor for VTE recurrence. The extent of influence of inherited thrombophilia on the risk of recurrence is controversial. Conversely, the presence of antiphospholipid antibodies, specifically triple positive carriers, appears to increase the risk of VTE recurrence. Understanding the rates of recurrent VTE in a patient and the individual risk of bleeding is important in determining the duration of anticoagulation therapy.
摘要
遗传性和获得性血栓形成倾向及高凝状态，如活动性癌症、雌激素诱导、自身免疫性疾病、大手术、住院和创伤，是众所周知的静脉血栓栓塞（VTE）危险因素。这些因素对复发性VTE的影响因每个特定危险因素而异。影响VTE复发的主要危险因素包括活动性癌症的存在和首次发生的不明原因VTE。此外，既往有雌激素相关VTE病史的女性使用复合雌激素是VTE复发的主要危险因素。遗传性血栓形成倾向对复发风险的影响程度存在争议。相反，抗磷脂抗体的存在，特别是三联阳性携带者，似乎会增加VTE复发的风险。了解患者复发性VTE的发生率和个体出血风险对于确定抗凝治疗的持续时间很重要。
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