青年人群中的静脉血栓栓塞症：RIETE 注册研究的结果。
Venous thromboembolism in young adults: Findings from the RIETE registry.
机构信息
Department of Internal Medicine, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
Department of Internal Medicine, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
出版信息
Eur J Intern Med. 2019 May;63:27-33. doi: 10.1016/j.ejim.2019.02.007. Epub 2019 Mar 11.
BACKGROUND
Little is known on the clinical characteristics, risk factors and outcomes during anticoagulation in young patients with acute venous thromboembolism (VTE).
METHODS
We used data from the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to assess the clinical characteristics, risk factors and outcomes during anticoagulation in VTE patients aged 10-24 years. Data were separately analyzed according to initial presentation and gender.
RESULTS
Of 76,719 patients with VTE, 1571 (2.0%) were aged 10-24 years. Of these, 989 (63%) were women and 669 (43%) presented with pulmonary embolism (PE). Most women were using estrogens (680, 69%) or were pregnant (101, 10%), while 59% of men had unprovoked VTE. Women were more likely to present with PE (48% vs. 34%). The majority (87%) of PE patients had Sat O levels ≥90% at baseline. The vast majority (97%) of PE patients were at low risk according to the PESI score, many (90%) at very low risk. During the course of anticoagulation (median, 192 days), 40 patients had VTE recurrences, 17 had major bleeding and 10 died (3 died of PE). Women had as many VTE recurrences as major bleeds (15 vs. 14 events), while men had many more VTE recurrences than major bleeding (25 vs. 3 events).
CONCLUSIONS
VTE is associated with low risk of short-term mortality in young adults. Noticeable gender differences exist in the risk factor profile and the risk of VTE recurrences and major bleeding in the course of anticoagulation.
背景
对于急性静脉血栓栓塞症（VTE）的年轻患者，抗凝过程中的临床特征、风险因素和结局知之甚少。
方法
我们使用 RIETE（血栓栓塞登记处）登记处的数据来评估 10-24 岁 VTE 患者抗凝过程中的临床特征、风险因素和结局。根据初始表现和性别分别分析数据。
结果
在 76719 例 VTE 患者中，有 1571 例（2.0%）年龄在 10-24 岁之间。其中，989 例（63%）为女性，669 例（43%）为肺栓塞（PE）。大多数女性正在使用雌激素（680 例，69%）或怀孕（101 例，10%），而 59%的男性患有无诱因 VTE。女性更有可能出现 PE（48% vs. 34%）。大多数（87%）PE 患者在基线时 Sat O 水平≥90%。根据 PESI 评分，绝大多数（97%）PE 患者为低危，许多（90%）为极低危。在抗凝过程中（中位数 192 天），40 例患者出现 VTE 复发，17 例患者出现大出血，10 例患者死亡（3 例死于 PE）。女性 VTE 复发与大出血事件数量相同（15 例 vs. 14 例），而男性 VTE 复发明显多于大出血（25 例 vs. 3 例）。
结论
在年轻成年人中，VTE 与短期死亡率低相关。在抗凝过程中，VTE 复发和大出血的风险因素和风险存在明显的性别差异。
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