Bork Konrad, Meng Gabriele, Staubach Petra, Hardt Jochen
Department of Dermatology, Johannes Gutenberg University, Mainz, Germany.
Transfusion. 2005 Nov;45(11):1774-84. doi: 10.1111/j.1537-2995.2005.00602.x.
Abdominal edema attacks in patients with hereditary angioedema are often extremely painful, associated with vomiting and diarrhea, and have a high potential for causing recurrent disability of the patient.
Intraindividual comparison of retrospective data in 75 hereditary angioedema patients comprising 4,834 abdominal attacks treated with C1 inhibitor concentrate versus 17,444 untreated abdominal attacks.
The mean duration of abdominal attacks was 92.0 hours (SD, 40.8 hr) when untreated compared to 39.9 hours (SD, 30.0 hr) when treated. Patients reported a mean maximal pain score of 8.6 (SD, 1.7; range, 1-10) for untreated attacks compared to 4.5 (SD, 2.9) when treated. Vomiting occurred in 83.3 percent of untreated attacks and in 6.0 percent of treated attacks, respectively. Diarrhea was reported in 41.8 percent of untreated attacks and in 11.0 percent of treated attacks, whereas cardiovascular collapse due to hypovolemia was observed in 3.5 percent of untreated attacks versus 0.1 percent in treated attacks. Mean time to relief of symptoms was 53.5 minutes when treated early compared to 114 minutes when treatment was delayed. No drug-related adverse or serious adverse events were observed as far as the injections were performed correctly.
C1 inhibitor concentrate is highly effective and safe in treating abdominal attacks in patients suffering from hereditary angioedema.
遗传性血管性水肿患者的腹部水肿发作通常极为疼痛,伴有呕吐和腹泻,且极有可能导致患者反复残疾。
对75例遗传性血管性水肿患者的回顾性数据进行个体内比较,其中包括4834次接受C1抑制剂浓缩物治疗的腹部发作与17444次未经治疗的腹部发作。
未经治疗时,腹部发作的平均持续时间为92.0小时(标准差40.8小时),而接受治疗时为39.9小时(标准差30.0小时)。患者报告未经治疗的发作平均最大疼痛评分为8.6(标准差1.7;范围1 - 10),而接受治疗时为4.5(标准差2.9)。呕吐分别发生在83.3%的未经治疗的发作和6.0%的接受治疗的发作中。腹泻在41.8%的未经治疗的发作和11.0%的接受治疗的发作中被报告,而因低血容量导致的心血管虚脱在3.5%的未经治疗的发作中观察到,在接受治疗的发作中为0.1%。早期治疗时症状缓解的平均时间为53.5分钟,而延迟治疗时为114分钟。只要注射操作正确,未观察到与药物相关的不良或严重不良事件。
C1抑制剂浓缩物在治疗遗传性血管性水肿患者的腹部发作方面高效且安全。