Poon Man-Chiu
Foothills Medical Centre, 1403-29th Street NW, Calgary, AB T2N 2T9, Canada.
Curr Hematol Rep. 2003 Mar;2(2):139-47.
The ability of high concentrations of recombinant factor VIIa (rFVIIa) to improve thrombin generation in in vitro and ex vivo models of thrombocytopenia, and to improve bleeding time in thrombocytopenic animal models supports a potential role for rFVIIa in the management of thrombocytopenic bleeding. Anecdotal reports suggest that rFVIIa is effective in the prevention and treatment of bleeding episodes in surgical procedures in a limited number of patients with severe thrombocytopenia. There is a need for clinical trials to determine whether rFVIIa is efficacious and safe in severe thrombocytopenic bleeding, either by itself or in combination with other hemostatic agents such as platelet transfusion. Pending the availability of such data, rFVIIa may be considered in severe thrombocytopenic bleeding that is unresponsive to human leukocyte antigen-compatible platelet transfusions and other standard treatments. If rFVIIa is used, unresolved issues include optional dosage, dosing interval, and whether rFVIIa is best used alone or in conjunction with platelet transfusion.
高浓度重组凝血因子VIIa（rFVIIa）在血小板减少症的体外和体内模型中改善凝血酶生成以及在血小板减少症动物模型中改善出血时间的能力，支持了rFVIIa在血小板减少性出血管理中的潜在作用。轶事报道表明，rFVIIa在少数严重血小板减少症患者的外科手术中预防和治疗出血发作有效。需要进行临床试验以确定rFVIIa单独或与其他止血剂（如血小板输注）联合使用时，在严重血小板减少性出血中是否有效和安全。在此类数据可用之前，对于对人类白细胞抗原相容的血小板输注和其他标准治疗无反应的严重血小板减少性出血，可考虑使用rFVIIa。如果使用rFVIIa，未解决的问题包括最佳剂量、给药间隔以及rFVIIa单独使用还是与血小板输注联合使用效果最佳。
