Natural history of mesenteric venous thrombosis in patients treated with vitamin K antagonists A multi-centre, retrospective cohort study
Natural history of mesenteric venous thrombosis in patients treated with vitamin K antagonists A multi-centre, retrospective cohort study
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DOI：
10.1160/th08-12-0842
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发表时间：
2009-09-01
影响因子：
6.7
通讯作者：
Crowther, Mark
中科院分区：
文献类型：
--
作者：
Dentali, Francesco;Ageno, Walter;Crowther, Mark
关于肠系膜静脉血栓形成 (MVT) 自然史以及长期口服抗凝治疗 (OAT) 的有效性和安全性的知识是基于小规模非对照患者系列和有限的随访。该研究的目的是评估接受 OAT 治疗的患者队列中 MVT 的自然史。对目前就诊或曾就诊过四个抗凝诊所的所有 MVT 患者的图表进行了审查。收集了有关危险因素、治疗、复发、大出血和死亡率的信息。 77 名患者（平均年龄 49.2 岁；45 名男性）被纳入其中，中位随访时间为 36 个月（范围 2-204 个月）。 46 名患者接受了长期 OAT 治疗。 7 名患者出现静脉血栓栓塞 (VTE) 复发（5 名内静脉血栓和 2 名肺栓塞），发病率为 23.4 次/1,000 名患者。两名患者在 OAT 期间发生复发性 VTE，发病率为 10.5 次事件/1,000 年患者。暂停 OAT 后，5 名患者出现 VTE 复发，发病率为 45.9 次/1,000 名患者。两名患者 (2.6%) 发生严重出血事件。 97.3% 的患者一年后仍存活，7 名患者 (9.1%) 在随访期间死亡。总之，MTV 患者在接受 OAT 时复发 VTE 的风险似乎较低。治疗停止后，这种风险似乎会增加。
Knowledge on the natural history of mesenteric vein thrombosis (MVT) and of the efficacy and safety of long-term oral anticoagulant therapy (OAT) in this setting is based on small uncontrolled series of patients with a limited follow-up. It was the aim of the study to assess the natural history of MVT in a cohort of patients treated with OAT. The charts of all MVT patients currently attending or who have attended four anticoagulation clinics were reviewed. Information on risk factors, treatment, recurrence, major bleeding and mortality was collected. Seventy-seven patients (mean age 49.2 years; 45 males) were included with a median follow-up of 36 months (range 2-204 months). Forty-six patients were treated with long-term OAT. Seven patients had venous thromboembolism (VTE) recurrence (5 splanchnic vein thromboses and two pulmonary emboli) for an incidence rate of 23.4 events /1,000 year patients. In two patients recurrentVTE occurred during OAT, for an incidence rate of 10.5 events /1,000 year patient. Five patients had VTE recurrence when OAT was suspened for an incidence rate of 45.9 events /1,000 year patient. Two patients (2.6%) had a major bleeding event. 97.3% of patients were alive at one year, and seven patients (9.1%) died during follow up. In conclusion, patients with MTV seem to have a low risk of recurrentVTE while receiving OAT. This risk appears increased after treatment is stopped.