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J Thromb Haemost:噬血细胞性淋巴组织细胞增生症成人出血和血栓栓塞发生率及其对总生存率的影响

2021-12-08 MedSci原创 MedSci原创

在噬血细胞性淋巴组织细胞增生症的成人中,VTE似乎比之前描述的更常见,并且是患者死亡的预测因子,尽管这可能是由于未经调整的混杂因素所致。由于出血率高,VTE的预防和治疗具有挑战性。

噬血细胞性淋巴组织细胞增生症是一种罕见的综合征,其特征是出现不受控制的免疫系统激活和较高的死亡风险。关于噬血细胞性淋巴组织细胞增生症患者出血和血栓栓塞发生率的数据很少。

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,该研究旨在明确噬血细胞性淋巴组织细胞增生症成人出血和血栓栓塞的累积发生率及其对患者生存率的影响。

研究人员在加拿大艾伯塔省(1999-2019年)对患有噬血细胞性淋巴组织细胞增生症的成人进行了一项多中心回顾性队列研究。研究人员计算了受试者出血和血栓栓塞的累积发生率,并考虑了竞争风险。Cox比例风险模型用于评估出血和血栓栓塞对受试者总生存(OS)的影响。

研究人员确定了97名噬血细胞性淋巴组织细胞增生症成人(中位年龄为46岁)。11名(11%)患者在入院后中位时间9天时发生了静脉血栓栓塞(VTE)。39名(40%)患者发生了ISTH大出血和临床相关的非大出血,中位时间为入院后16天。血小板计数最低点(调整后的比值比[aOR]为1.8/log下降,95%置信区间[CI]为1.2-2.8)和机械通气(aOR为4.9,95%CI为1.8-14.8)是多变量分析中出血的独立预测因子。调整竞争风险后,90天出血和血栓栓塞的累积发生率分别为39%和13%。中位OS为18.8个月。VTE,但不是出血,与不良OS显著相关(调整后的HR为2.5,95%CI为1.1-5.7)。

由此可见,在噬血细胞性淋巴组织细胞增生症的成人中,VTE似乎比之前描述的更常见,并且是患者死亡的预测因子,尽管这可能是由于未经调整的混杂因素所致。由于出血率高,VTE的预防和治疗具有挑战性。

 原始出处:
 
Jennifer Croden,et al.Incidence of bleeding and thromboembolism and impact on overall survival in adult patients with hemophagocytic lymphohistiocytosis: A 20-year provincial retrospective cohort study.Journal of Thrombosis and Haemostasis.2021.https://onlinelibrary.wiley.com/doi/10.1111/jth.15615

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    2023-04-16 侠胆医心 来自香港

    #噬血细胞性淋巴组织细胞增生症#成人出血和#血栓栓塞#发生率及其对总生存率的影响

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Dec 09 07:51:48 CST 2021, time=2021-12-09, status=1, ipAttribution=)]
    2022-01-01 changfy
  5. 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  6. 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  7. 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    2021-12-09 查查佳佳

    测完了肉女的头上午班淘口令卡西欧

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2126253, encodeId=aba32126253a2, content=<a href='/topic/show?id=05534035637' target=_blank style='color:#2F92EE;'>#噬血细胞性淋巴组织细胞增生症#</a>成人出血和<a href='/topic/show?id=23c58911686' target=_blank style='color:#2F92EE;'>#血栓栓塞#</a>发生率及其对总生存率的影响, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40356, encryptionId=05534035637, topicName=噬血细胞性淋巴组织细胞增生症), TopicDto(id=89116, encryptionId=23c58911686, topicName=血栓栓塞)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=侠胆医心, createdTime=Sun Apr 16 13:40:55 CST 2023, time=2023-04-16, status=1, ipAttribution=香港), GetPortalCommentsPageByObjectIdResponse(id=1826757, encodeId=f3cb1826e57a5, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Fri Jul 01 21:13:54 CST 2022, time=2022-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1805209, encodeId=44fd18052099c, content=<a href='/topic/show?id=3138e790655' target=_blank style='color:#2F92EE;'>#细胞性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77906, encryptionId=3138e790655, topicName=细胞性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Sat Oct 22 19:13:54 CST 2022, time=2022-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008545, encodeId=aacb200854530, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Jan 01 15:13:54 CST 2022, time=2022-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681889, encodeId=4df61681889e5, content=<a href='/topic/show?id=2fb489882cb' target=_blank style='color:#2F92EE;'>#血细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89882, encryptionId=2fb489882cb, topicName=血细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a79127868468, createdName=ailian1211, createdTime=Wed Feb 23 11:13:54 CST 2022, time=2022-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256868, encodeId=133a1256868f3, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Fri Dec 10 13:13:54 CST 2021, time=2021-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1078356, encodeId=7f4b10e835631, content=测完了肉女的头上午班淘口令卡西欧, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Thu Dec 09 09:33:34 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1078320, encodeId=e8ee10e832094, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c90a5343088, createdName=ms5000000833449414, createdTime=Thu Dec 09 08:41:12 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1078306, encodeId=f36010e830635, content=学习了,以前也没注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200807/fb49ede2bc714e14abb1a1024e3f6969/ca936d1263ab48ffba726dafc70bcdb2.jpg, createdBy=92c35391508, createdName=冷小落, createdTime=Thu Dec 09 07:51:48 CST 2021, time=2021-12-09, status=1, ipAttribution=)]
    2021-12-09 ms5000000833449414

    学习了

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2126253, encodeId=aba32126253a2, content=<a href='/topic/show?id=05534035637' target=_blank style='color:#2F92EE;'>#噬血细胞性淋巴组织细胞增生症#</a>成人出血和<a href='/topic/show?id=23c58911686' target=_blank style='color:#2F92EE;'>#血栓栓塞#</a>发生率及其对总生存率的影响, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40356, encryptionId=05534035637, topicName=噬血细胞性淋巴组织细胞增生症), TopicDto(id=89116, encryptionId=23c58911686, topicName=血栓栓塞)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/Random/55971dc507c93968175ce7cc1e177b372a83869f.jpg, createdBy=f63e4754896, createdName=侠胆医心, createdTime=Sun Apr 16 13:40:55 CST 2023, time=2023-04-16, status=1, ipAttribution=香港), GetPortalCommentsPageByObjectIdResponse(id=1826757, encodeId=f3cb1826e57a5, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, 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href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Jan 01 15:13:54 CST 2022, time=2022-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1681889, encodeId=4df61681889e5, content=<a href='/topic/show?id=2fb489882cb' target=_blank style='color:#2F92EE;'>#血细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89882, encryptionId=2fb489882cb, topicName=血细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a79127868468, createdName=ailian1211, createdTime=Wed Feb 23 11:13:54 CST 2022, time=2022-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256868, encodeId=133a1256868f3, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Fri Dec 10 13:13:54 CST 2021, time=2021-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1078356, encodeId=7f4b10e835631, content=测完了肉女的头上午班淘口令卡西欧, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Thu Dec 09 09:33:34 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1078320, encodeId=e8ee10e832094, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c90a5343088, createdName=ms5000000833449414, createdTime=Thu Dec 09 08:41:12 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1078306, encodeId=f36010e830635, content=学习了,以前也没注意, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200807/fb49ede2bc714e14abb1a1024e3f6969/ca936d1263ab48ffba726dafc70bcdb2.jpg, createdBy=92c35391508, createdName=冷小落, createdTime=Thu Dec 09 07:51:48 CST 2021, time=2021-12-09, status=1, ipAttribution=)]
    2021-12-09 冷小落

    学习了,以前也没注意

    0

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