Deep vein thrombosis: current status and nanotechnology advances.
Deep vein thrombosis: current status and nanotechnology advances.
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DOI：
10.1016/j.biotechadv.2012.08.004
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发表时间：
2013-09
影响因子：
16
通讯作者：
Nguyen, Kytai T.
中科院分区：
文献类型：
--
作者：
Wadajkar, Aniket S.;Santimano, Sonia;Rahimi, Maham;Yuan, Baohong;Banerjee, Subhash;Nguyen, Kytai T.
在美国，深静脉血栓形成(DVT)影响着多达200万人，全球发病率为每年每10万人中有70至113例。DVT的死亡通常是由于随后的肺栓塞(PE)。因此，准确的诊断和治疗对深静脉血栓的治疗至关重要。DVT的诊断是通过全面的病史和体格检查，然后进行实验室和诊断测试。实验室和诊断试验的选择取决于临床预试的概率。现有的实验室和诊断技术主要包括D-二聚体试验、超声、静脉造影和磁共振成像。后两种诊断工具需要高剂量的造影剂，包括放射性或有毒物质。可用的治疗选择包括改变生活方式、机械压迫、抗凝治疗、下腔静脉滤器和溶栓/取栓。所有这些内科和外科治疗都有严重的副作用，包括不适当的清除血栓和增加出血发生的风险。因此，近年来，这一领域的研究主要集中在无创、准确的诊断方法上，如超声增强技术和分子成像方法，以评估血栓的位置及其治疗过程。纳米医学的前沿也显示出通过有效的靶向药物输送来治疗DVT的巨大前景。这篇综述描述了DVT的病理以及继发的医学问题，如PE，并详细列出了已经使用和正在开发的各种诊断和治疗方法。
Deep vein thrombosis (DVT) affects up to 2 million people in the United States, and worldwide incidence is 70 to 113 cases per 100,000 per year. Mortality from DVT is often due to subsequent pulmonary embolism (PE). Precise diagnosis and treatment is thereby essential for the management of DVT. DVT is diagnosed by a thorough history and physical examination followed by laboratory and diagnostic tests. The choice of laboratory and diagnostic test is dependent on clinical pretest probability. Available laboratory and diagnostic techniques mainly involve D-dimer test, ultrasound, venography, and magnetic resonance imaging. The latter two diagnostic tools require high doses of contrast agents including either radioactive or toxic materials. The available treatment options include lifestyle modifications, mechanical compression, anticoagulant therapy, inferior vena cava filter, and thrombolysis/thrombolectomy. All of these medical and surgical treatments have serious side effects including improper clot clearance and increased risk of hemorrhage occurrence. Therefore, research in this field has recently focused on the development of non-invasive and accurate diagnostics, such as ultrasound enhanced techniques and molecular imaging methods, to assess thrombus location and its treatment course. The frontier of nanomedicine also shows high prospects in tackling DVT with efficient targeted drug delivery. This review describes the pathology of DVT along with successive medical problems such as PE and features a detailed listing of various diagnostic and therapeutic modalities that have been in use and are under development.
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