Hampton K K, Makris M, Kitchen S, Preston F E
Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK.
Blood Coagul Fibrinolysis. 1991 Oct;2(5):637-41. doi: 10.1097/00001721-199110000-00008.
We have studied the potential thrombogenicity of two different heat-treated prothrombin complex concentrates (PCC) in patients with Haemophilia B. Seven patients were studied on nine separate occasions. Four of the patients had chronic hepatitis C (HCV) associated liver disease and three were HIV-antibody positive. The PCCs were Profilnine (Alpha Therapeutics, Thetford, UK) and 9A (Bio-Products Laboratory, Elstree, UK) and the dose administered ranged from 35 to 60 U/kg. Blood samples were taken on ten separate occasions; twice before the infusion and at 15, 40, 60, 75 and 120 min and 4, 8 and 24 h after the infusion of PCC. Investigations included prothrombin time, kaolin cephalin clotting time, thrombin time, fibrin(ogen) degradation products, factor VIII, factor IX, antithrombin III and fibrinopeptide A (FPA). Fibrinopeptide A rises were seen following two of six infusions of 9A and one of three infusions of Profilnine. On all three occasions the rise in FPA was transient, returning to baseline levels within 120 min. Plasma beta-thromboglobulin (BTG) was assayed in three patients and in one patient, the rise in FPA was followed by an increase in BTG. No other changes were observed and there were no clinical features of disseminated intravascular coagulation. Our results indicate that even with normal clinical doses of PCC, intravascular thrombin generation can occur in patients with Haemophilia B. However, this effect is inconsistent both with respect to PCC batch and patient, but may occur in the absence of HIV infection and HCV liver disease.
我们研究了两种不同热处理的凝血酶原复合物浓缩剂（PCC）对乙型血友病患者的潜在致血栓形成性。对7名患者进行了9次单独研究。其中4名患者患有慢性丙型肝炎（HCV）相关肝病，3名患者HIV抗体呈阳性。使用的PCC分别为Profilnine（英国阿尔法治疗公司，塞特福德）和9A（英国生物制品实验室，埃尔斯特里），给药剂量范围为35至60 U/kg。在10个不同时间点采集血样；在输注PCC前两次，以及输注后15、40、60、75和120分钟，以及4、8和24小时。检测项目包括凝血酶原时间、高岭土部分凝血活酶时间、凝血酶时间、纤维蛋白（原）降解产物、因子VIII、因子IX、抗凝血酶III和纤维蛋白肽A（FPA）。在6次输注9A中的2次以及3次输注Profilnine中的1次后观察到FPA升高。在所有这3次情况下，FPA的升高都是短暂的，在120分钟内恢复到基线水平。对3名患者检测了血浆β-血小板球蛋白（BTG），在1名患者中，FPA升高后BTG也升高。未观察到其他变化，也没有弥散性血管内凝血的临床特征。我们的结果表明，即使使用正常临床剂量的PCC，乙型血友病患者也可能发生血管内凝血酶生成。然而，这种效应在PCC批次和患者方面都不一致，但在没有HIV感染和HCV肝病的情况下也可能发生。
