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去氨加压素(DDAVP)在先天性出血性疾病患者管理中的应用。

Desmopressin (DDAVP) in the management of patients with congenital bleeding disorders.

机构信息

Section of Hematology and Medical Oncology, Tulane University, New Orleans, LA, USA.

出版信息

Haemophilia. 2014 Mar;20(2):158-67. doi: 10.1111/hae.12254. Epub 2013 Aug 12.

Abstract

Bleeding disorders, including haemophilia, von Willebrand disease, and platelet function abnormalities pose a substantial, ongoing management challenge. Patients with these disorders not only require treatment during bleeding events but also need effective management strategies to prepare for events ranging from minor dental procedures to major surgery and childbirth. Moreover, women with bleeding disorders often require ongoing treatment to prevent menorrhagia during childbearing years. Desmopressin (DDAVP), a synthetic derivative of the antidiuretic hormone l-arginine vasopressin, has become a well-established tool for the management of patients with bleeding disorders in a variety of clinical settings. However, despite the widespread use of DDAVP, the available clinical evidence on its efficacy and safety in these settings is limited, and there has not been a recent comprehensive review of its role in the clinical management of patients with bleeding disorders. As such, this article provides a review of the mechanism of action and pharmacokinetic properties of DDAVP, followed by a concise summary of the available evidence for its use in the treatment and prevention of bleeding.

摘要

出血性疾病,包括血友病、血管性血友病和血小板功能异常,是一个持续存在的重大管理挑战。这些疾病的患者不仅在出血事件中需要治疗,而且需要有效的管理策略来预防从轻微的牙科手术到重大手术和分娩等各种事件。此外,患有出血性疾病的女性在生育期往往需要持续治疗以预防月经过多。去氨加压素(DDAVP)是抗利尿激素 l-精氨酸血管加压素的合成衍生物,已成为在各种临床环境中管理出血性疾病患者的一种成熟工具。然而,尽管 DDAVP 广泛应用,但在这些环境中关于其疗效和安全性的现有临床证据有限,而且最近也没有对其在出血性疾病患者临床管理中的作用进行全面审查。因此,本文综述了 DDAVP 的作用机制和药代动力学特性,随后简要总结了其在治疗和预防出血方面的应用证据。

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