정맥혈전증의 최신 치료: 항응고치료를 중심으로
Current Management of Pulmonary Thromboembolism
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초록
국내 정맥혈전증의 발생 빈도는 2008년 7,300명당 1명이 발생하였다고 보고되었지만 점차 증가하는 추세로 지속적인 관찰이 필요하다. 정맥혈전증의 항응고치료 기간은 최소 3개월 이상으로 출혈위험이 크지 않고 재발의 위험이 큰 경우 연장치료가 필요하며 정기적인 평가가 필요하다. 표준치료인 와파린을 투여하는 경우 치료 구간 내 시간을 통해 치료의 질적 관리를 평가할 수 있고 표준화된 용량조절 알고리듬을 이용함으로써 질적 향상을 가져올 수 있다. 또한 표준 항응고치료제인 와파린의 단점을 보완한 새로운 경구용 항응고제는 모니터링 없이도 재발 및 출혈 발생률에서 표준치료와 비교하여 유사하거나 우월하였으며 신기능장애가 있는 환자에게 투여할 때는 감량 및 기간 연장 등 세심한 주의를 요한다.
Abstract
The incidence of venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) is increasing in Korea. In addition, awareness of VTE according to the incidence is improving, but how long VTE should be treated and how effective VTE patients should be managed with warfarin is not well defined. Recently, various new oral anticoagulants (NOACs) were introduced in clinical practice. The duration of anticoagulation, quality control of warfarin, and practical use of NOACs in VTE would be reviewed with evidences.
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