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重组人凝血酶在小儿烧伤切痂术中的安全性和免疫原性。

Recombinant human thrombin: safety and immunogenicity in pediatric burn wound excision.

机构信息

Arizona Burn Center at Maricopa Medical Center, Phoenix, AZ, USA.

出版信息

J Pediatr Surg. 2011 Oct;46(10):1992-9. doi: 10.1016/j.jpedsurg.2011.05.022.

Abstract

BACKGROUND

Previous studies of recombinant human thrombin (rThrombin) enrolled adult and adolescent patients. This phase 4, open-label, single-group study was conducted in pediatric patients undergoing synchronous burn wound excision and skin grafting to provide information regarding the safety and immunogenicity of rThrombin (primary and secondary endpoints) in this population.

METHODS

Topical rThrombin was applied as a hemostatic aid during a surgical procedure (day 1). Adverse events and clinical laboratory abnormalities were recorded during the study. Immunogenicity samples were collected on days 1 and 29 (study end). Study results were summarized with descriptive statistics.

RESULTS

Thirty patients enrolled and 28 completed the study. Mean age was 6.9 years (range, 0.9-17.8 years); 40.0% of patients were girls. Flame and scald were the most common burn types (33.3% each, n = 10/30). Mean graft size was 3.6% total body surface area. Procedural pain (50.0% patients), pruritus (43.3%), and anemia (30.0%) were the most commonly reported adverse events. All adverse events and clinical laboratory abnormalities were considered unrelated to treatment. No patients developed anti-rThrombin product antibodies at day 29.

CONCLUSIONS

In pediatric patients undergoing burn wound excision and skin grafting, rThrombin was well tolerated and did not lead to the formation of anti-rThrombin product antibodies.

摘要

背景

先前关于重组人凝血酶(rThrombin)的研究纳入了成年和青少年患者。本 4 期、开放性、单组研究纳入了正在接受同步烧伤创面切除和皮肤移植的儿科患者,旨在提供 rThrombin 在该人群中的安全性和免疫原性信息(主要和次要终点)。

方法

在手术过程中(第 1 天)局部应用 rThrombin 作为止血辅助剂。在研究期间记录不良事件和临床实验室异常。在第 1 天和第 29 天(研究结束时)采集免疫原性样本。使用描述性统计方法总结研究结果。

结果

共纳入 30 例患者,28 例完成研究。平均年龄为 6.9 岁(范围,0.9-17.8 岁);40.0%的患者为女性。火焰烧伤和烫伤是最常见的烧伤类型(各占 33.3%,n=10/30)。平均植皮面积为 3.6%总体表面积。最常报告的不良事件为操作疼痛(50.0%的患者)、瘙痒(43.3%)和贫血(30.0%)。所有不良事件和临床实验室异常均被认为与治疗无关。在第 29 天,没有患者产生抗 rThrombin 产品抗体。

结论

在接受烧伤创面切除和皮肤移植的儿科患者中,rThrombin 耐受性良好,不会导致抗 rThrombin 产品抗体的形成。

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