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J Thromb Haemost:A型和B型血友病患者出血的危险因素分析

2022-04-16 MedSci原创 MedSci原创

在构建PWH出血RAM时,血浆凝血因子水平、出血史应作为推导分析的依据,并应探讨包括抗血栓治疗和肥胖在内的其他危险因素的作用。

血友病治疗的基础是凝血因子不足的治疗。在预防出血和关节疾病方面,常规预防已被证明优于间歇性的按需治疗。然而,血友病(PWH)患者采用相似的常规预防方案治疗可能会导致不同的出血模式。识别高危出血患者是降低出血风险的重要第一步。此外,调整一些已知的危险因素有助于选择能从治疗中获益的患者。了解血友病(PWH)患者出血的风险对患者、利益相关者和政策制定者都是相关的。

近日,血栓和凝血疾病权威杂志Journal of Thrombosis and Haemostasis上发表了一篇研究文章,该研究旨在系统地回顾有关PWH定期预防出血的风险评估模型(RAMs)和风险因素的文献。

研究人员检索了MEDLINE、EMBASE、Cochrane中央对照试验登记册和Cochrane系统评价数据库,检索时间从数据库成立到2019年8月。研究人员筛选了纳入的文章,提取数据,并使用QUIPS工具评估偏倚风险。由于危险因素、结局定义和指标以及结果的统计分析存在高度异质性,因此没有对结果进行定性合成分析。

在1843项检索结果中,有10项研究符合纳入标准。没有发现RAM对PWH出血风险的影响。大多数研究只包括PWH A或PWH A和B,并在北美或欧洲进行。只有一项较低偏倚风险的研究纳入了所有领域,确定了八类危险因素。当凝血因子水平较低时,出血风险增加,且患者有明显的出血史。

由此可见,该研究的结果表明,在构建PWH出血RAM时,血浆凝血因子水平、出血史应作为推导分析的依据,并应探讨包括抗血栓治疗和肥胖在内的其他危险因素的作用。

 

原始出处:
 
Federico Germini.et al.Risk factors for bleeding in people living with Hemophilia A and B treated with regular prophylaxis: a systematic review of the literature.Journal of Thrombosis and Haemostasis.2022.https://onlinelibrary.wiley.com/doi/epdf/10.1111/jth.15723.

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    2022-07-07 changfy
  2. [GetPortalCommentsPageByObjectIdResponse(id=2008573, encodeId=1be220085e3b4, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Thu Jul 07 07:08:46 CST 2022, time=2022-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1211643, encodeId=4df41211643dd, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuGj39AkCCRO8MexYCxSr6Xlg6ZTAHlicnEB24mbsD1FApD8aOepA9dQ5v1ntBgbUJqPAjkDibKMBibl/0, createdBy=d7332112515, createdName=ms5567494310035831, createdTime=Sat Apr 16 12:51:14 CST 2022, time=2022-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1211664, encodeId=4c3e12116644e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210302/d7aef29f1c284560b978861e2a96fbb2/c495254e3ce54350a8a4f1eb91e884c8.jpg, createdBy=15e55464744, createdName=坚定的心, createdTime=Sat Apr 16 14:48:03 CST 2022, time=2022-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1211637, encodeId=f085121163e4f, content=认真学习~~, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cfb41991958, createdName=xulv123, createdTime=Sat Apr 16 12:10:20 CST 2022, time=2022-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322412, encodeId=028413224128e, content=<a href='/topic/show?id=8a23382430' target=_blank style='color:#2F92EE;'>#B型血友病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3824, encryptionId=8a23382430, topicName=B型血友病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3516494, createdName=spoonycyy, createdTime=Fri Apr 15 03:08:46 CST 2022, time=2022-04-15, status=1, ipAttribution=)]
    2022-04-16 ms5567494310035831

    学习了!

    0

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    2022-04-16 坚定的心

    学习了

    0

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    2022-04-16 xulv123

    认真学习~~

    0

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