Kobrinsky N L, Israels E D, Bickis M G
Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
Am J Pediatr Hematol Oncol. 1991 Winter;13(4):437-41. doi: 10.1097/00043426-199124000-00008.
Desmopressin and ethamsylate were evaluated for possible synergistic effects on the bleeding time. The drugs were administered individually and together to 12 patients with markedly prolonged bleeding times known to be relatively or absolutely unresponsive to desmopressin alone. The bleeding disorders studied included Glanzmann's thrombasthenia (one), other disorders of platelet function (four), pseudo-von Willebrand disease (one), and von Willebrand disease type I (three), type II (two), and type III (one). Desmopressin alone shortened the bleeding time from 23.9 +/- 1.5 to 19.5 +/- 2.3 min (p = 0.03). Ethamsylate alone was without effect. Desmopressin and ethamsylate together shortened the bleeding time to 11.2 +/- 1.4 min (p less than 0.01 compared to baseline, p = 0.02 compared to desmopressin alone). The combination was ineffective in three patients, with Glanzmann's thrombasthenia (one), and von Willebrand disease type I (one) and type III (one). Toxic effects of the drugs were not observed. Five patients received desmopressin and ethamsylate prior to dental work with mandibular block (one), heart surgery requiring cardiopulmonary bypass (two), and adenotonsillectomy surgery (two). Normal hemostasis was achieved in each case. A synergistic shortening of the bleeding time was observed with the combination of desmopressin and ethamsylate in a wide range of bleeding disorders.
评估了去氨加压素和酚磺乙胺对出血时间可能的协同作用。将这些药物单独及联合给予12例出血时间明显延长的患者，已知这些患者对单独使用去氨加压素相对或绝对无反应。所研究的出血性疾病包括Glanzmann血小板无力症（1例）、其他血小板功能障碍（4例）、假性血管性血友病（1例）以及血管性血友病I型（3例）、II型（2例）和III型（1例）。单独使用去氨加压素可使出血时间从23.9±1.5分钟缩短至19.5±2.3分钟（p = 0.03）。单独使用酚磺乙胺则无效果。去氨加压素和酚磺乙胺联合使用可使出血时间缩短至11.2±1.4分钟（与基线相比p<0.01，与单独使用去氨加压素相比p = 0.02）。该联合用药对3例患者无效，包括Glanzmann血小板无力症（1例）、血管性血友病I型（1例）和III型（1例）。未观察到药物的毒性作用。5例患者在进行下颌阻滞牙科手术（1例）、需要体外循环的心脏手术（2例）和腺样体扁桃体切除术（2例）之前接受了去氨加压素和酚磺乙胺治疗。在每种情况下均实现了正常止血。在多种出血性疾病中，观察到去氨加压素和酚磺乙胺联合使用可协同缩短出血时间。
