al-Momen A K, Huraib S O, Gader A M, Sulaimani F
Department of Medicine, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
Thromb Res. 1991 Dec 1;64(5):527-32.
Two patients (one male and one female) with end stage renal disease on chronic hemodialysis were treated with recombinant human erythropoietin (r-HuEPO). Both patients developed significant clotting in the vascular access and extracorporeal circuits. Coagulation studies indicated that both patients acquired high levels of tissue-type plasminogen activator inhibitor (PAI) with deficiency in tissue-type plasminogen activator (t-PA) and consequent impaired fibrinolysis. Their fibrinolytic activity was normalized with danazol therapy in doses as low as 2-4 mg/kg given orally once daily. We conclude that r-HuEPO-induced thrombosis is associated with impaired fibrinolysis due to acquired elevation of PAI which can be effectively prevented by small doses of danazol.
两名患有终末期肾病并接受慢性血液透析的患者（一男一女）接受了重组人促红细胞生成素（r-HuEPO）治疗。两名患者的血管通路和体外循环均出现严重凝血。凝血研究表明，两名患者均获得了高水平的组织型纤溶酶原激活物抑制剂（PAI），同时组织型纤溶酶原激活物（t-PA）缺乏，导致纤维蛋白溶解受损。通过每日口服低至2-4mg/kg剂量的达那唑治疗，他们的纤维蛋白溶解活性恢复正常。我们得出结论，r-HuEPO诱导的血栓形成与PAI获得性升高导致的纤维蛋白溶解受损有关，小剂量达那唑可有效预防这种情况。
