Lethagen S, Harris A S, Nilsson I M
Department of Coagulation Disorders, University of Lund, Malmö General Hospital, Sweden.
Blut. 1990 Mar;60(3):187-91. doi: 10.1007/BF01720274.
Desmopressin acetate (1-desamino-8-D-arginine vasopressin, DDAVP) has mostly been given by the parenteral route for the treatment of mild hemophilia A and von Willebrand's disease type I. In the present study the hemostatic effects of desmopressin acetate administered intranasally by spray in a dose of 300 micrograms and intravenously 0.3-0.4 micrograms/kg were assessed and compared in 8 patients with hemophilia A and 22 patients with von Willebrand's disease type I. A bioequivalent response to intravenous and intranasal desmopressin acetate was found in Factor VIII coagulant activity (VIII:C) in the hemophilia patients. In the von Willebrand patients, an equivalent shortening of the bleeding time was seen after the two modes of administration, even though intravenous injection gave a higher increase in plasma levels of VIII:C and vWF:Ag. In five patients with von Willebrand's disease the duration of the spray effect on VIII:C and vWF:Ag was followed for 24 h. After 12 h the mean level of VIII:C was 1.4, and of vWF:Ag 1.5, times the basal level. The findings suggest that the spray can be recommended for home or prophylactic treatment of patients with mild hemophilia A and von Willebrand's disease.
醋酸去氨加压素（1-去氨基-8-D-精氨酸血管加压素，DDAVP）大多通过肠胃外途径给药，用于治疗轻度甲型血友病和Ⅰ型血管性血友病。在本研究中，对8例甲型血友病患者和22例Ⅰ型血管性血友病患者评估并比较了以300微克剂量喷雾鼻内给药和以0.3 - 0.4微克/千克静脉注射醋酸去氨加压素的止血效果。在血友病患者中，发现静脉注射和鼻内给予醋酸去氨加压素后，因子VIII凝血活性（VIII:C）有生物等效反应。在血管性血友病患者中，两种给药方式后出血时间均有同等程度缩短，尽管静脉注射使血浆VIII:C和vWF:Ag水平升高幅度更大。对5例血管性血友病患者，观察了喷雾对VIII:C和vWF:Ag的作用持续24小时。12小时后，VIII:C的平均水平为基础水平的1.4倍，vWF:Ag为1.5倍。这些发现提示，喷雾可推荐用于轻度甲型血友病和Ⅰ型血管性血友病患者的家庭治疗或预防性治疗。
