Vrij Anton A, Oberndorff-Klein-Woolthuis Ardi, Dijkstra Gerard, de Jong Andrea E, Wagenvoord Rob, Hemker Hendrik C, Stockbrügger Reinhold W
Department of Internal Medicine and Gastroenterology, Twenteborg Hospital Almelo, Zilvermeeuw 1, PB 7600, 7600 SZ Almelo, The Netherlands.
J Thromb Thrombolysis. 2007 Oct;24(2):175-82. doi: 10.1007/s11239-006-9046-z. Epub 2007 Feb 17.
In ulcerative colitis (UC), a state of hypercoagulation has frequently been observed. Low molecular weight heparin (LMWH) has shown beneficial effects as an adjuvant treatment of steroid refractory UC in open trials. We assessed potential therapeutic effects of the LMWH reviparin in hospitalised patients with mesalazine refractory UC, as well as its influence on haemostasis factors.
Twenty-nine patients with mild-to-moderately active UC were included in a double-blind placebo controlled trial. All patients had a flare-up of disease under mesalazine treatment. Reviparin (Clivarin) 3,436 IU anti-Xa/0.6 ml or placebo s.c. was added, and self-administered twice daily for 8 weeks. Patients were monitored for possible adverse events and changes in clinical symptoms. Endoscopical, histological, biochemical and haemostasis parameters were analysed.
Tolerability and compliance were excellent and no serious adverse events occurred. No significant differences were observed on the clinical, endoscopical and histological outcome, as compared to placebo. A high intrinsic and extrinsic thrombin potential was found before LMWH therapy. However, the significant reduction in the thrombin generation by LMWH was not related to the reduction in disease activity.
The LMWH reviparine reduces thrombin generation in patients with mild-to-moderately active, mesalazine refractory UC, but is not associated with a reduction in disease activity.
在溃疡性结肠炎（UC）中，经常观察到高凝状态。在开放试验中，低分子量肝素（LMWH）作为类固醇难治性UC的辅助治疗已显示出有益效果。我们评估了LMWH瑞伐肝素对住院的美沙拉嗪难治性UC患者的潜在治疗效果及其对止血因子的影响。
29例轻度至中度活动性UC患者纳入双盲安慰剂对照试验。所有患者在美沙拉嗪治疗期间病情均有发作。添加瑞伐肝素（Clivarin）3436 IU抗Xa/0.6 ml或安慰剂皮下注射，患者自行给药，每日两次，共8周。监测患者可能出现的不良事件和临床症状变化。分析内镜、组织学、生化和止血参数。
耐受性和依从性良好，未发生严重不良事件。与安慰剂相比，在临床、内镜和组织学结果方面未观察到显著差异。在LMWH治疗前发现内源性和外源性凝血酶潜力较高。然而，LMWH导致的凝血酶生成显著减少与疾病活动度降低无关。
LMWH瑞伐肝素可降低轻度至中度活动性、美沙拉嗪难治性UC患者的凝血酶生成，但与疾病活动度降低无关。
