静脉血栓栓塞症患者口服抗凝药物导致出血的多因素分析研究  

Multifactor analysis on hemorrhage caused by oral anticoagulants in patients with venous thromboembolism

作　　者：姚莉[1] 赵生俊[1] 唐晓丽[2] YAO Li;ZHAO Shengjun;TANG Xiaoli(Department of Pharmacy;Department of Pulmonary Disease,Affiliated Hospital of Traditional Chinese Medicine,Xinjiang Medical University,Urumchi,Xinjiang 830000,China)

机构地区：[1]新疆医科大学附属中医医院药学部,乌鲁木齐830000 [2]新疆医科大学附属中医医院肺病科,乌鲁木齐830000

出　　处：《重庆医学》2022年第22期3895-3898,3902,共5页Chongqing medicine

基　　金：新疆维吾尔自治区药学会科研基金项目(YXH201804)。

摘　　要：目的分析影响静脉血栓栓塞症(VTE)患者使用直接口服抗凝药物(DOAC)出血的相关因素,以提高其临床用药的安全性。方法分析2018年1月至2020年12月收治于该院肺病科和血管外科给予DOAC治疗的VTE 301例患者为临床资料,对可能引起出血的相关因素进行单因素及多因素logistic回归分析。结果94例(31.3%)患者存在出血,其中大出血7例,临床相关非大出血42例,小出血45例。常见的出血类型为消化道出血共42例(44.6%)。logistic回归分析显示,影响DOAC治疗出血的危险因素为血栓性疾病诊断(OR=1.42)、合并使用特殊药物(OR=2.23)、合并特殊病情(OR=1.62)、肾功能(OR=4.56)。结论DOAC使用时应加强VTE患者出血风险的评估及特殊情况下的治疗药物监测以保证临床用药的安全性。Objective To analyze the related factors of hemorrhage caused by direct oral anticoagulants(DOAC)in the patients with venous thromboembolism,to improve the safety of clinical medication.Methods The clinical datas of 301 VTE patients treated with DOAC only in the Pulmonary Department and Vascular surgery department of the hospital from January 2018 to December 2020 were analyzed,univariate and multivariate logistic regression analysis were performed on the related factors that may cause bleeding.Results A total of 94 cases(31.32%)had hemorrhage,including 7 cases of massive hemorrhage,42 cases of clinical related non-massive hemorrhage and 45 cases of small hemorrhage.The common hemorrhage type was the digestive tract hemorrhage,which contained 42 cases(44.6%).The logistic regression analysis revealed that the risk factors affecting the hemorrhage treated with DOAC were the diagnosis of thrombotic disease(OR=1.42),combined use of special drugs(OR=2.23),combined with special disease condition(OR=1.62)and renal function(OR=4.56).Conclusion It is necessary to strengthen the evaluation of hemorrhage risk of the VTE patients and treatment drug monitoring under the particular cases when using DOAC inorder to guarantee the clinical medication safety.

关 键 词：直接口服抗凝药物 出血 静脉血栓栓塞 影响因素 

分 类 号：R543.6[医药卫生—心血管疾病]