Kulka P J, Tryba M, Lange S
Abteilung für Anästhesiologie und Intensivmedizin Evangelisches Krankenhaus Oberhausen.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2001 Mar;36(3):143-53. doi: 10.1055/s-2001-11815.
The serine-protease-inhibitor antithrombin III (AT III) has often been recommended for the therapy of septic patients as it provides anticoagulant and antiinflammatory actions. In animal studies the prophylactic treatment with AT III in a dose > 250 U/kg prevented the development of disseminated intravascular coagulopathy and vital organ dysfunction during sepsis and lowered the mortality rate. In clinical studies with septic patients therapy usually was started several hours after the start of the disease in dosages much lower than those used in animal studies. In these patients AT III-therapy improved laboratory changes of disseminated intravascular coagulopathy but was unable to lower the mortality rate. Hereditary AT III deficiency, lack of heparin effect due to low AT III levels, disseminated intravascular coagulation disorders are indications for the use of AT III while beneficial effects of AT III in patients suffering from SIRS, sepsis or septic shock have not yet been demonstrated.
丝氨酸蛋白酶抑制剂抗凝血酶III（AT III）常被推荐用于脓毒症患者的治疗，因为它具有抗凝和抗炎作用。在动物研究中，以大于250 U/kg的剂量预防性使用AT III可预防脓毒症期间弥散性血管内凝血和重要器官功能障碍的发生，并降低死亡率。在脓毒症患者的临床研究中，治疗通常在疾病开始数小时后开始，所用剂量远低于动物研究中的剂量。在这些患者中，AT III治疗改善了弥散性血管内凝血的实验室指标变化，但未能降低死亡率。遗传性AT III缺乏、由于AT III水平低导致肝素效应缺乏、弥散性血管内凝血障碍是使用AT III的指征，而AT III对全身炎症反应综合征、脓毒症或脓毒性休克患者的有益作用尚未得到证实。
