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BMJ:伦敦大学发布 血液稀释剂药物有可能增加这类人群的中风风险

2018-02-15 佚名 Medicalxpress

65岁以上的人如果患有慢性肾病,服用抗凝血剂可能增加他们的中风风险。

65岁以上的人如果患有慢性肾病,服用抗凝血剂可能增加他们的中风风险。

此结果来自伦敦大学和萨里大学的研究人员领导的一项新的研究。基于他们的发现,今天发表在《英国医学杂志》上,研究人员说,在更多的研究能够澄清这样做的后果之前,医生应该更加谨慎地规定抗凝剂,也称为血液稀释剂。

“慢性肾脏病在老年人中是常见的,而在受影响的三人中有一人也患有房颤,通常被称为不规则心跳,因此,他们通常会得到规定的血液稀释剂以降低其中风的风险。我们发现,在这一特定人群中,他们的药物似乎与预期效果相反。”

研究人员估计,近50万以上的英国65岁以上的人患有慢性肾脏疾病和房颤。伦敦大学圣乔治临床心脏病学教授约翰.坎姆教授说:“患有慢性肾脏病的人往往会出现许多严重的并发症,包括心血管疾病。因为他们的血液凝块更多,但它们也会更容易出血,因此在不同治疗之间的平衡是极其困难的。我们发现,随着中风和大出血发病率的增加,死亡率降低,这显然是一个非常复杂的领域。我们强烈呼吁随机对照研究来检验房颤和慢性肾病患者抗凝药物治疗的临床价值和安全性。”

在基于人群的回顾性队列研究中,研究人员在65岁以上患有慢性肾病和新诊断的房颤患者中,确定了4848人,其中一半是抗凝血剂,一半为非抗凝血剂。对参与者进行了506天的中位数监测。在研究期间,服用抗凝血剂的参与者有2.6倍中风风险, 2.4倍可能发生出血。对于抗凝剂而言,缺血性中风的粗率为4.6%,而非血液稀释剂的患者为1.5%。

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