癌因性凝血病Trousseau综合征研究进展

Research Progress in Cancer-related Coagulopathy Trousseau's Syndrome

静脉血栓栓塞(VTE)具有可变性,但是更易出现在那些患有恶性肿瘤的患者身上,患有胰腺癌且脑部或颈部有肿瘤的患者发生的比例则更高。VTE的风险在患有恶性腺瘤的患者中比患有细胞癌的患者高。有高级病毒肿瘤的患者风险高于低级病毒的患者。免疫调节药物,或者使用泰莫西芬的内分泌治疗均会增加患者的危险。与癌症有关的VTE很可能是多种因素导致的。"魏克氏三连征",淤血导致血流量的降低,也增加了血栓出现的可能。D-二聚体和P-选择素能够提升VTE的集聚概率。VTE的预防和治疗均依赖于成熟的药物,而且阿司匹林也可以避免动脉血栓的形成并且减少主要血管事件。对于癌症患者和留置中心静脉导管患者的静脉血栓栓塞的一般性处理的指南已经开发,可以针对具体的医疗情况选择最理性的治疗方式。

Venous thmmboembolism （VTE） is variable, but it＇s more likely to appear in patients with malignant tumors, with the highest odds in those with pancreatic cancer followed by head and neck tumors. In terms of histotype, the risk of VTE is significantly higher in patients with adenecarcinoma than in those with squamous cell carcinoma and in patients with hlgh-grade versus low-grade tumors. Immunomodulatory drugs and hormonal therapy with tamoxifen place patients at higher risk. The pathogenesis of cancer-related VTE is likely to he multifactorial. ＂Virohow＇s triad,＂ comprising stasis consequent to a decreased blood flow rate, an enhanced blood clotting tendency. D-dimer and soluble P-selectin, may improve the probability of VTE accu- mulation. The prophylaxis and treatment of VTE are based on well-established drugs. Furthermore, aspirin has been shown to prevent arterial thrombosis and reduce the rate of major vascular events. Guidelines for the general management of VTE in cancer patients and in those with an indwelling central venous catheter have been recently developed with the aim of selecting the most rational therapeutic approach for each clinical situ- ation.