长期服用抗血小板及抗凝药物的患者在介入操作期间如何使用这些药物，是微创医学界关注的焦点之一，《局部麻醉与疼痛医学》杂志编辑部组织专家编写了Interventional Spineand Pain Procedures in Patiems on Antiplatelet and Anticoag...长期服用抗血小板及抗凝药物的患者在介入操作期间如何使用这些药物，是微创医学界关注的焦点之一，《局部麻醉与疼痛医学》杂志编辑部组织专家编写了Interventional Spineand Pain Procedures in Patiems on Antiplatelet and Anticoagulant Medications（抗血小板和抗凝患者行脊柱介入和疼痛介入治疗指南），我刊委托华盛顿大学易晓彬教授洽谈版权并组织翻译，因篇幅较长，分三期刊出（22卷6～8期），参考文献请查阅原文（Doi：10．109711AAE0000000000000223，Reg Anesth Pain Med，2015，40：182～212）。展开更多
We report the case of a 44-year-old male with a 10-year history of manifestations of the rare form of bullous systemic lupus erythematosus (SLE) with coexisting antiphospholipid syndrome (APS) that remained undiagnose...We report the case of a 44-year-old male with a 10-year history of manifestations of the rare form of bullous systemic lupus erythematosus (SLE) with coexisting antiphospholipid syndrome (APS) that remained undiagnosed until thromboticembolic episodes appeared and high titres of anticardiolipin (ACL) antibodies were detected.The patient fulfilled the criteria for SLE and the atypical cutaneous manifestations together with histopathological changes and a favourable response to sulphones were the grounds for the diagnosis of the bullous variety of SLE.Treatment with prednisolone, acenocoumarol and dapsone resulted in marked clinical improvement, reduction in antinuclear antibodies (ANAs) and normalization of ACL antibody titres.展开更多
This trial evaluated the efficacy and safety of the combination of antiplatelet and moderate-intensity anticoagulation therapy in patients with atrial fibrillation associated with recognized risk factors or mitral ste...This trial evaluated the efficacy and safety of the combination of antiplatelet and moderate-intensity anticoagulation therapy in patients with atrial fibrillation associated with recognized risk factors or mitral stenosis. Warfarin was more effective than aspirin in preventing stroke in these patients; combined therapy with low anticoagulant intensity was ineffective. Mitral stenosis patients were not investigated. We performed a multicenter randomized trial in 1,209 patients at risk. The intermediate-risk group included patients with risk factors or age >60 years: 242 received the cyclooxygenase inhibitor triflusal, 237 received acenocumarol, and 235 received a combination of both. The high-risk group included patients with prior embolism or mitral stenosis: 259 received anticoagulants and 236 received the combined therapy. Median follow-up was 2.76 years. Primary outcome was a composite of vascular death and nonfatal stroke or systemic embolism. Primary outcome was lower in the combined therapy than in the anticoagulant arm in both the intermediate-(hazard ratio0.33 [95%confidence interval(CI)0.12 to 0.91]; p=0.02) and the high-risk group(HR 0.51[95%CI 0.27 to 0.96]; p=0.03). Primary outcome plus severe bleeding was lower with combined therapy in the intermediate-risk group. Nonvalvular and mitral stenosis patients had similar embolic event rates during anticoagulant therapy. The combined antiplatelet plus moderate-intensity anticoagulation therapy significantly decreased the vascular events compared with anticoagulation alone and proved to be safe in atrial fibrillation patients.展开更多
文摘长期服用抗血小板及抗凝药物的患者在介入操作期间如何使用这些药物，是微创医学界关注的焦点之一，《局部麻醉与疼痛医学》杂志编辑部组织专家编写了Interventional Spineand Pain Procedures in Patiems on Antiplatelet and Anticoagulant Medications（抗血小板和抗凝患者行脊柱介入和疼痛介入治疗指南），我刊委托华盛顿大学易晓彬教授洽谈版权并组织翻译，因篇幅较长，分三期刊出（22卷6～8期），参考文献请查阅原文（Doi：10．109711AAE0000000000000223，Reg Anesth Pain Med，2015，40：182～212）。
文摘We report the case of a 44-year-old male with a 10-year history of manifestations of the rare form of bullous systemic lupus erythematosus (SLE) with coexisting antiphospholipid syndrome (APS) that remained undiagnosed until thromboticembolic episodes appeared and high titres of anticardiolipin (ACL) antibodies were detected.The patient fulfilled the criteria for SLE and the atypical cutaneous manifestations together with histopathological changes and a favourable response to sulphones were the grounds for the diagnosis of the bullous variety of SLE.Treatment with prednisolone, acenocoumarol and dapsone resulted in marked clinical improvement, reduction in antinuclear antibodies (ANAs) and normalization of ACL antibody titres.
文摘This trial evaluated the efficacy and safety of the combination of antiplatelet and moderate-intensity anticoagulation therapy in patients with atrial fibrillation associated with recognized risk factors or mitral stenosis. Warfarin was more effective than aspirin in preventing stroke in these patients; combined therapy with low anticoagulant intensity was ineffective. Mitral stenosis patients were not investigated. We performed a multicenter randomized trial in 1,209 patients at risk. The intermediate-risk group included patients with risk factors or age >60 years: 242 received the cyclooxygenase inhibitor triflusal, 237 received acenocumarol, and 235 received a combination of both. The high-risk group included patients with prior embolism or mitral stenosis: 259 received anticoagulants and 236 received the combined therapy. Median follow-up was 2.76 years. Primary outcome was a composite of vascular death and nonfatal stroke or systemic embolism. Primary outcome was lower in the combined therapy than in the anticoagulant arm in both the intermediate-(hazard ratio0.33 [95%confidence interval(CI)0.12 to 0.91]; p=0.02) and the high-risk group(HR 0.51[95%CI 0.27 to 0.96]; p=0.03). Primary outcome plus severe bleeding was lower with combined therapy in the intermediate-risk group. Nonvalvular and mitral stenosis patients had similar embolic event rates during anticoagulant therapy. The combined antiplatelet plus moderate-intensity anticoagulation therapy significantly decreased the vascular events compared with anticoagulation alone and proved to be safe in atrial fibrillation patients.
