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首页> 外文期刊>Circulation journal >Current Venous Thromboembolism Management and Outcomes in Japan – Nationwide The Japan Venous Thromboembolism Treatment Registry Observational Study –
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Current Venous Thromboembolism Management and Outcomes in Japan – Nationwide The Japan Venous Thromboembolism Treatment Registry Observational Study –

机译：日本目前的静脉血栓栓塞管理和结果-全国范围日本的静脉血栓栓塞治疗注册观察研究–

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Background: ?Epidemiology and clinical management of acute venous thromboembolism (VTE) are not readily available in Japan. Methods and Results: ?The Japan VTE Treatment Registry (JAVA) is a multicenter cohort study of consecutive patients with an objectively confirmed, symptomatic acute pulmonary embolism (PE), symptomatic acute deep vein thrombosis (DVT), or asymptomatic acute proximal DVT. Of the 1,076 patients enrolled with acute VTE, 68.7% presented with an isolated DVT; 17.0% had PE alone; and 14.4% had both. VTE management was characterized by a high rate of inferior vena cava filter insertion (40.6%), frequent thrombolysis (21.1%), and sub-therapeutic unfractionated heparin-based anticoagulation, followed by warfarin prescription, mostly targeting an international normalized ratio of 2.0 (range, 1.5–2.5). During a mean observation period of 252.5 days, 29 recurrent cases of VTE were documented, yielding an incidence rate of 3.9 per 100 patient-years. A total of 123 patients died during the study period, corresponding to a rate of 16.6 deaths per 100 patient-years. The incidence of major bleeding was 3.2% per patient-year, including 2 fatal hemorrhages and 7 intracranial hemorrhages. Conclusions: ?VTE management in Japan is characterized by a highly aggressive strategy in the acute phase, in contrast to protocols that use low-level anticoagulation. The VTE recurrence rates in Japan and Western countries are similar, but mortality is higher in Japan, with significant variability depending on patient and management characteristics.??( Circ J ?2014; 78: 708–717)
机译：背景：日本尚无急性静脉血栓栓塞症（VTE）的流行病学和临床管理。方法和结果：日本VTE治疗注册中心（JAVA）是一项多中心队列研究，该研究针对具有客观确诊的有症状急性肺栓塞（PE），有症状急性深静脉血栓形成（DVT）或无症状急性近端DVT的连续患者。在1,076例接受急性VTE的患者中，有68.7％的患者表现为孤立的DVT。仅PE占17.0％;和14.4％的人都有。 VTE管理的特点是下腔静脉滤器插入率高（40.6％），频繁的溶栓（21.1％）和亚治疗性肝素基于普通肝素的抗凝治疗，随后采用华法林处方，主要针对国际标准化比例为2.0（范围1.5-2.5）。在252.5天的平均观察期内，记录了29例VTE复发病例，每100患者年3.9的发生率。在研究期间共有123名患者死亡，相当于每100个患者年16.6例死亡。每位患者每年的大出血发生率为3.2％，包括2例致命出血和7例颅内出血。结论：与采用低水平抗凝治疗的方案相比，日本的VTE管理在急性期具有高度积极的治疗策略。日本和西方国家的VTE复发率相似，但日本的死亡率较高，其差异取决于患者和治疗的特点。（Circ J？2014; 78：708-717）

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