{"id":142769,"date":"2023-01-11T01:55:36","date_gmt":"2023-01-11T01:55:36","guid":{"rendered":"https:\/\/labinsights.com\/acf_article\/thrombosis-risk-and-anticoagulation-in-hospitalized-patients-insights-from-prof-alex-c-spyropoulos\/"},"modified":"2026-01-20T06:44:24","modified_gmt":"2026-01-20T06:44:24","slug":"thrombosis-risk-and-anticoagulation-in-hospitalised-patients-insights-from-prof-alex-c-spyropoulos","status":"publish","type":"acf_article","link":"https:\/\/labinsights.com\/ja\/disease-area\/covid-19\/thrombosis-risk-and-anticoagulation-in-hospitalised-patients-insights-from-prof-alex-c-spyropoulos\/","title":{"rendered":"Thrombosis risk and anticoagulation in hospitalized patients: insights from Prof Alex C Spyropoulos"},"content":{"rendered":"

2022\u5e743\u6708\u306b\u6700\u5f8c\u306b\u958b\u50ac\u3055\u308c\u305f\u3001Roche Diagnostics \u4e3b\u50ac\u306e\u8840\u6db2\u51dd\u56fa\u306b\u95a2\u3059\u308b\u5e74\u6b21\u306e\u79d1\u5b66\u30fb\u6559\u80b2\u30a4\u30d9\u30f3\u30c8 pro-COAG \u306b\u304a\u3044\u3066<\/a>\u3001\u30db\u30d5\u30b9\u30c8\u30e9\u30fb\u30ce\u30fc\u30b9\u30a6\u30a7\u30eb\u306e Zucker School of Medicine \u306e\u533b\u5b66\u6559\u6388\u3067\u3042\u308a\u3001\u30ce\u30fc\u30b9\u30a6\u30a7\u30eb\u30fb\u30d8\u30eb\u30b9\u30b7\u30b9\u30c6\u30e0\u306e\u6297\u51dd\u56fa\u30fb\u8840\u6813\u75c7\u30b5\u30fc\u30d3\u30b9\u306e\u30c7\u30a3\u30ec\u30af\u30bf\u30fc\u3092\u52d9\u3081\u308b Alex C. Spyropoulos \u6559\u6388\u304c\u3001\u5165\u9662\u60a3\u8005\u306e\u8840\u6813\u75c7\u7ba1\u7406\u306b\u3064\u3044\u3066\u8b1b\u6f14\u3057\u307e\u3057\u305f\u3002\u672c\u767a\u8868\u3067\u306f\u3001\u9000\u9662\u5f8c\u306e\u6025\u6027\u671f\u60a3\u8005\u304a\u3088\u3073\u91cd\u75c7 SARS-CoV-2\uff08COVID-19\uff09\u60a3\u8005\u306b\u304a\u3051\u308b\u8840\u6813\u4e88\u9632\uff08\u30b9\u30ed\u30f3\u30dc\u30d7\u30ed\u30d5\u30a3\u30e9\u30af\u30b7\u30b9\uff09\u306b\u7126\u70b9\u304c\u5f53\u3066\u3089\u308c\u307e\u3057\u305f\u3002<\/p>\n

\u7c73\u56fd\u304a\u3088\u3073EU\u5168\u4f53\u3067\u63a8\u5b9a2,000\u4e07\u4eba\u306e\u60a3\u8005\u304c\u9759\u8108\u8840\u6813\u585e\u6813\u75c7\uff08VTE\uff09\u306e\u30ea\u30b9\u30af\u306b\u3055\u3089\u3055\u308c\u3066\u304a\u308a\u3001\u3053\u306e\u72b6\u6cc1\u306f\u91cd\u5ea6\u306eCOVID-19\u306b\u95a2\u9023\u3057\u305f\u904e\u51dd\u56fa\u72b6\u614b\u306b\u3088\u3063\u3066\u3055\u3089\u306b\u60aa\u5316\u3057\u3066\u3044\u307e\u3059\u3002COVID-19\u75c7\u4f8b\u3092\u9664\u5916\u3059\u308b\u3068\u3001\u75c7\u5019\u6027VTE\u306e50\u301c70\uff05\u3001\u81f4\u6b7b\u6027\u80ba\u585e\u6813\u75c7\uff08PE\uff09\u306e70\u301c80\uff05\u306f\u3001\u6025\u6027\u671f\u306e\u5185\u79d1\u75be\u60a3\u3067\u5165\u9662\u3057\u3066\u3044\u308b\u60a3\u8005\u306b\u767a\u751f\u3057\u307e\u3059\u3002\u3053\u308c\u3089\u306e\u60a3\u8005\u306f\u300170\u6b73\u4ee5\u4e0a\u3067\u3042\u308b\u3053\u3068\u30013\u65e5\u4ee5\u4e0a\u306e\u9577\u671f\u9593\u81e5\u5e8a\u3001\u4e0d\u5145\u5206\u306a\u5faa\u74b0\u4e88\u5099\u80fd\u3001\u307e\u305f\u306f\u8840\u6813\u30ea\u30b9\u30af\u3092\u9ad8\u3081\u308b\u8907\u6570\u306e\u4f75\u5b58\u75c7\u3092\u6709\u3059\u308b\u3053\u3068\u304c\u7279\u5fb4\u3067\u3059[1]\u3002<\/p>\n

\u81e8\u5e8a\u73fe\u5834\u3067\u306f\u3001\u5165\u9662\u60a3\u8005\u306e\u8840\u6813\u4e88\u9632\u306f\u8a31\u5bb9\u3067\u304d\u306a\u3044\u9ad8\u3044\u51fa\u8840\u30ea\u30b9\u30af\u3092\u4f34\u3046\u3053\u3068\u306a\u304f\u8840\u6813\u5408\u4f75\u75c7\u306e\u767a\u751f\u7387\u3092\u4f4e\u4e0b\u3055\u305b\u307e\u3059\u3002\u4e00\u65b9\u3067\u3001\u5165\u9662\u671f\u9593\u306e\u77ed\u7e2e\u306b\u3088\u308a\u3001\u7ba1\u7406\u306e\u8ca0\u62c5\u304c\u5916\u6765\u8a3a\u7642\u3078\u79fb\u884c\u3059\u308b\u72b6\u6cc1\u304c\u751f\u3058\u3066\u3044\u307e\u3059\u3002\u3055\u3089\u306b\u3001VTE\u306e80\uff05\u306f\u9000\u9662\u5f8c6\u9031\u9593\u4ee5\u5185\u306b\u767a\u751f\u3057\u307e\u3059\u304c\u3001\u9000\u9662\u6642\u306b\u8840\u6813\u4e88\u9632\u3092\u53d7\u3051\u3066\u3044\u308b\u5165\u9662\u60a3\u8005\u306f4\uff05\u672a\u6e80\u306b\u3068\u3069\u307e\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n

\u533b\u7642\u5f93\u4e8b\u8005\u304a\u3088\u3073\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f\u3001\u3053\u306e\u9000\u9662\u5f8c\u306e\u9ad8\u30ea\u30b9\u30af\u671f\u9593\u3092\u9069\u5207\u306b\u8a8d\u8b58\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002\u5916\u6765\u3067\u306e\u76f4\u63a5\u7d4c\u53e3\u6297\u51dd\u56fa\u85ac\uff08DOAC\uff1a\u30ea\u30d0\u30fc\u30ed\u30ad\u30b5\u30d0\u30f3\u304a\u3088\u3073\u30d9\u30c8\u30ea\u30ad\u30b5\u30d0\u30f3\uff09\u306b\u3088\u308b\u4e88\u9632\u6cbb\u7642\u306e\u8a66\u9a13\u3067\u306f\u3001\u9ad8VTE\u30ea\u30b9\u30af\u304b\u3064\u4f4e\u51fa\u8840\u30ea\u30b9\u30af\u306e\u96c6\u56e3\u3092\u9069\u5207\u306b\u9078\u629e\u3059\u308b\u3053\u3068\u3001\u305d\u3057\u3066\u500b\u5225\u5316\u3055\u308c\u305f\u30ea\u30b9\u30af\u9069\u5fdc\u578b\u30a2\u30d7\u30ed\u30fc\u30c1\u3092\u9069\u7528\u3059\u308b\u3053\u3068\u306e\u91cd\u8981\u6027\u304c\u5f37\u8abf\u3055\u308c\u3066\u3044\u307e\u3059[2,3]\u3002\u00a0Padua \u3084 IMPROVE+D-dimer \u306a\u3069\u306e\u30d0\u30ea\u30c7\u30fc\u30b7\u30e7\u30f3\u6e08\u307f VTE \u30ea\u30b9\u30af\u30e2\u30c7\u30eb\u3084\u30c4\u30fc\u30eb\u3092\u5165\u9662\u6642\u304a\u3088\u3073\u9000\u9662\u6642\u306b\u9069\u7528\u3059\u308b\u3053\u3068\u3067\u3001\u610f\u601d\u6c7a\u5b9a\u306b\u5f79\u7acb\u3061\u307e\u3059\u304c\u3001\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f\u4f9d\u7136\u3068\u3057\u3066\u6df7\u5728\u3057\u3066\u3044\u307e\u3059[4,5]\u3002<\/p>\n

SARS-CoV-2 \u306f\u3001\u95a2\u9023\u3057\u3066\u3044\u306a\u304c\u3089\u3082\u7570\u306a\u308b\u8ab2\u984c\u3092\u63d0\u793a\u3057\u307e\u3059\u3002\u611f\u67d3\u304c\u4ecb\u5728\u3057\u305f\u8840\u7ba1\u6a5f\u80fd\u969c\u5bb3\u3068\u708e\u75c7\u6027\u30b5\u30a4\u30c8\u30ab\u30a4\u30f3\uff0f\u51dd\u56fa\u30d1\u30e9\u30e1\u30fc\u30bf\u4e0a\u6607\u306e\u7d44\u307f\u5408\u308f\u305b\u306b\u3088\u308a\u3001\u975e\u5b9a\u578b\u306e\u51dd\u56fa\u4ea2\u9032\u72b6\u614b\u304c\u8a98\u5c0e\u3055\u308c\u307e\u3059\u3002\u3053\u306e\u72b6\u614b\u306e\u30de\u30fc\u30ab\u30fc\u306b\u306f\u3001VTE \u306e 3\u301c5 \u500d\u306e\u5897\u52a0\u7387\u3001D-\u30c0\u30a4\u30de\u30fc\u5024\u306e\u6b63\u5e38\u4e0a\u9650\u306e 4\u301c6 \u500d\u4ee5\u4e0a\u306e\u4e0a\u6607\uff08\u6b7b\u4ea1\u7387\u306e 2\u301c5 \u500d\u306e\u5897\u52a0\u306b\u95a2\u9023\uff09\u3001\u7570\u5e38\u306a\u51dd\u56fa\u30bf\u30a4\u30d4\u30f3\u30b0\u3001\u304a\u3088\u3073\u8840\u6813\u6027\u30d6\u30ec\u30fc\u30af\u30b9\u30eb\u30fc\u304c\u542b\u307e\u308c\u307e\u3059[6]\u3002<\/p>\n

\u3057\u305f\u304c\u3063\u3066\u3001DOAC \u304a\u3088\u3073\u4f4e\u5206\u5b50\u91cf\u30d8\u30d1\u30ea\u30f3\uff08LMWH\uff09\u306b\u3088\u308b\u8840\u6813\u4e88\u9632\u306e\u30bf\u30a4\u30df\u30f3\u30b0\u3068\u6295\u4e0e\u91cf\u304c\u6975\u3081\u3066\u91cd\u8981\u306b\u306a\u308a\u307e\u3059\u3002 \u8a31\u5bb9\u3067\u304d\u306a\u3044\u307b\u3069\u9ad8\u3044\u51fa\u8840\u30ea\u30b9\u30af\u306e\u306a\u3044\u3059\u3079\u3066\u306e COVID-19 \u5165\u9662\u60a3\u8005\u306f\u3001\u4e88\u9632\u7684\uff08\u4f4e\u7528\u91cf\uff09LMWH \u306b\u3088\u308b\u30e6\u30cb\u30d0\u30fc\u30b5\u30eb\u8840\u6813\u4e88\u9632\u3092\u53d7\u3051\u308b\u3079\u304d\u3067\u3059\u304c\u3001\u6b63\u5e38\u5024\u306e\u4e0a\u9650\u3092\u8d85\u3048\u308b 2\u301c3 \u500d\u306e D-\u30c0\u30a4\u30de\u30fc\u4e0a\u6607\u304c\u8a8d\u3081\u3089\u308c\u308b\u9ad8\u30ea\u30b9\u30af\u7fa4\u306a\u3069\u3001\u7279\u306b\u30ea\u30b9\u30af\u306e\u9ad8\u3044\u60a3\u8005\u3067\u306f\u3001\u6cbb\u7642\u7528\u91cf LMWH\uff08\u9ad8\u7528\u91cf LMWH\uff09\u3092\u7528\u3044\u305f\u8840\u6813\u4e88\u9632\u304c\u63a8\u5968\u3055\u308c\u307e\u3059\u3002<\/p>\n

\u3055\u3089\u306b\u3001IMPROVE VTE \u30b9\u30b3\u30a2\u304c 4 \u70b9\u4ee5\u4e0a\u3001\u307e\u305f\u306f\u30b9\u30b3\u30a2 2\u301c3 \u3067 D-\u30c0\u30a4\u30de\u30fc\u5024\u304c\u5c40\u6240\u691c\u67fb\u6b63\u5e38\u4e0a\u9650\u306e 2 \u500d\u4ee5\u4e0a\u306b\u4e0a\u6607\u3057\u3066\u3044\u308b\u60a3\u8005\u306f\u3001\u51fa\u8840\u30ea\u30b9\u30af\u304c\u4f4e\u3044\u9650\u308a\u3001\u30ea\u30d0\u30fc\u30ed\u30ad\u30b5\u30d0\u30f3 10 mg \u3092 35 \u65e5\u9593\u6295\u4e0e\u3059\u308b\u9577\u671f\u9000\u9662\u5f8c\u8840\u6813\u4e88\u9632\u304b\u3089\u6069\u6075\u3092\u5f97\u308b\u3068\u793a\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u6539\u8a02\u3055\u308c\u305f COVID-19 \u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f\u3001\u3053\u308c\u3089\u306e\u52d5\u5411\u3092\u53cd\u6620\u3059\u308b\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n

Alex C. Spyropoulos \u6559\u6388\u306f\u3001Zucker School of Medicine \u306e\u533b\u5b66\u6559\u6388\u3067\u3042\u308a\u3001Northwell Health System \u306e\u6297\u51dd\u56fa\u30fb\u81e8\u5e8a\u8840\u6813\u75c7\u30b5\u30fc\u30d3\u30b9\u306e\u30c7\u30a3\u30ec\u30af\u30bf\u30fc\u3092\u52d9\u3081\u3066\u3044\u307e\u3059\u3002 NY \u306b\u6240\u5728\u3059\u308b Feinstein Institute for Medical Research \u306e Health Innovations and Outcomes \u30bb\u30f3\u30bf\u30fc\u306e\u6559\u6388\u3092\u52d9\u3081\u3066\u3044\u307e\u3059\u3002 \u3055\u3089\u306b\u3001Northwell Health System \u306e\u8840\u6813\u75c7\u30ea\u30fc\u30c0\u30fc\u30b7\u30c3\u30d7\u8a55\u8b70\u4f1a\u306e\u5171\u540c\u8b70\u9577\u3092\u52d9\u3081\u3066\u304a\u308a\u3001 Thrombosis and Haemostasis \u306e\u30bb\u30af\u30b7\u30e7\u30f3\u30a8\u30c7\u30a3\u30bf\u30fc\u3001 \u304a\u3088\u3073 Hospital Medicine \u8a8c\u306e\u7de8\u96c6\u59d4\u54e1\u3082\u52d9\u3081\u3066\u3044\u307e\u3059\u3002<\/em><\/p>\n

\u53c2\u8003\u6587\u732e\uff1a<\/em><\/p>\n

\n

\u00a0[1]<\/a> Decousus, H, et al.Chest, 2011. 139(1):69\u201379.
\n[2]<\/a> Spyropoulos, AC, et al. TH Open, 2020. 04(01):e59\u2013e65.
\n[3]<\/a> Cohen, AT, et al., J Thromb Haemost, 2014. 12(4):479\u2013487.
\n[4]<\/a> Spyropoulos, AC, et al.Res Pract Thromb Haemost, 2021. 5(2):296\u2013300.
\n[5]<\/a> Rosenberg, DJ, et al.Thromb Haemost, 2016. 116(09):530\u2013536.
\n[6]<\/a> Goldin, M, et al.J Thromb Thrombolysis, 2021. 52(4):1032\u20131035.<\/p>\n","protected":false},"excerpt":{"rendered":"

2022\u5e743\u6708\u306b\u6700\u5f8c\u306b\u958b\u50ac\u3055\u308c\u305f\u3001Roche Diagnostics \u4e3b\u50ac\u306e\u8840\u6db2\u51dd\u56fa\u306b\u95a2\u3059\u308b\u5e74\u6b21\u306e\u79d1\u5b66\u30fb\u6559\u80b2\u30a4\u30d9\u30f3\u30c8 pro-COAG \u306b\u304a\u3044\u3066\u3001\u30db\u30d5\u30b9\u30c8\u30e9\u30fb\u30ce\u30fc\u30b9\u30a6\u30a7\u30eb\u306e Zucker School of Medicine \u306e\u533b\u5b66\u6559\u6388\u3067\u3042\u308a\u3001\u30ce\u30fc\u30b9\u30a6\u30a7\u30eb\u30fb\u30d8\u30eb\u30b9\u30b7\u30b9\u30c6\u30e0\u306e\u6297\u51dd\u56fa\u30fb\u8840\u6813\u75c7\u30b5\u30fc\u30d3\u30b9\u306e\u30c7\u30a3\u30ec\u30af\u30bf\u30fc\u3092\u52d9\u3081\u308b Alex C. Spyropoulos \u6559\u6388\u304c\u3001\u5165\u9662\u60a3\u8005\u306e\u8840\u6813\u75c7\u7ba1\u7406\u306b\u3064\u3044\u3066\u8b1b\u6f14\u3057\u307e\u3057\u305f\u3002\u672c\u767a\u8868\u3067\u306f\u3001\u9000\u9662\u5f8c\u306e\u6025\u6027\u671f\u60a3\u8005\u304a\u3088\u3073\u91cd\u75c7 SARS-CoV-2\uff08COVID-19\uff09\u60a3\u8005\u306b\u304a\u3051\u308b\u8840\u6813\u4e88\u9632\uff08\u30b9\u30ed\u30f3\u30dc\u30d7\u30ed\u30d5\u30a3\u30e9\u30af\u30b7\u30b9\uff09\u306b\u7126\u70b9\u304c\u5f53\u3066\u3089\u308c\u307e\u3057\u305f\u3002 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