摘要
目的 通过分析血液系统疾病造血干细胞移植后血小板减少合并出血病例,评估应用重组人凝血因子Ⅶa（rFⅦa）的疗效,以期寻求安全、有效的止血药物.方法 回顾性分析2012年10月—2016年10月收治的25例造血干细胞移植后血小板减少合并出血患者,分析各患者在rFⅦa治疗前后血常规、血凝常规、肝肾功能等实验室指标的变化,分析rFⅦa的有效性及安全性.结果 分析25例患者数据,治疗总体有效率为64％,中位起效时间为2.5（1～5）h.随访1个月,总出血相关死亡率为80％（8/10）.rFⅦa应用后72 h,血小板及新鲜冰冻血浆输注需求量较前缩小,浓缩红细胞输注量在使用前后无明显改变.分析rFⅦa疗效与各因素相关性显示患者年龄、疾病、移植类型、出血部位、出血评分、出血时血小板计数、出血发生至rFⅦa应用时间以及出血时血凝指标均与rFⅦa疗效无明显相关.结论 rFⅦa是治疗allo-HSCT血小板减少合并重度出血的一种安全有效的重要药物.
Objective To evaluate the efficacy and safety of factor Ⅶa by analyzing the treatment of thrombocytopenia patients associated with severe hemorrhage post allogeneic hematopoietic stem cell transplantation. Methods A total of 25 appropriate patients from Oct 2012 to Oct 2016 in the First Affiliated Hospital of Soochow University were included in this study. By analyzing the patients＇ blood routine, blood clot routine, hepatorenal function before and after rⅦa treatment, to estimate the efficacy and safety of factor Ⅶa. Results Among these 25 patients, the overall response rate was 64%, the median effective time was 2.5 （1 - 5） h, the hemorrhage related mortality was 80% （8/10） in 1 month. Platelet and fresh frozen plasma transfusion requirements were reduced in 72 h after rFⅦausing. Conclusion rFⅦa is an effective and safety drug for the treatment of thrombocytopenia associated with severe hemorrhage post allogeneic hematopoietic stem cell transplantation.
作者
宋铁梅
唐雅琼
张翔
冯宇锋
SONG Tie-mei;TANG Ya-qiong;ZHANG Xiang;FENG Yu-feng(Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China)
出处
《中国血液流变学杂志》
CAS
2017年第4期382-385,共4页
Chinese Journal of Hemorheology
关键词
造血干细胞移植
重度出血
血小板减少
重组人凝血因子Ⅶa
hematopoietic stem cell transplantation
severe hemorrhage
thrombocytopenia
recombinantfactor Ⅶa
