Pei Bing-bing, Li Chao-yue, Lu Xin, Wu Xing, Gao Liang, Yu Jian, Wu Xue-hai, Jin Yi, Sun Yi-rui, Du Zhuo-ying, Mao Ying, Hu Jin, Zhou Liang-fu
Department of Neurosurgery, Affiliated Huashan Hospital, Fudan University, Shanghai 200040, China.
Zhonghua Yi Xue Za Zhi. 2013 Jun 18;93(23):1780-3.
To explore the role of small-dose recombinant human coagulation factor VIIa (rFVIIa) for coagulopathy in patients with isolated traumatic brain injury.
A total of 86 isolated traumatic brain patients with coagulopathy were treated at our neurosurgery intensive care unit (NICU) from January 2010 to December 2012. Their trauma registry data included mortality, pre-and post-rFVIIa coagulation parameters. Two-tailed paired t-test was used to determine significant changes in coagulation parameters and other major clinical parameters.
Twenty-seven patients made up the low-dose rFVIIa (20 µg/kg) group. And the control group had 59 well-matched subjects. At admission, age, blood pressure, Glasgow coma scale score, hemoglobin, platelets and international normalize ratio were similar in both groups. After treatment, the INR of patients on rFVIIa was lower than that of the conventional treatment group (1.1 ± 0.2 vs 1.2 ± 0.2, P < 0.01) and it declined more in the rFVIIa group (0.3 ± 0.2 vs 0.1 ± 0.4, P = 0.05). No significant difference existed in mortality or length of stay between two groups.There was no occurrence of subsequent thromboembolic events.
The application of small-dose rFVIIa can effectively reduce the value of INR and improve the coagulation status of patients. During the course of treatment, no major adverse events occur.
探讨小剂量重组人凝血因子VIIa（rFVIIa）在单纯性创伤性脑损伤患者凝血病中的作用。
2010年1月至2012年12月，在我院神经外科重症监护病房（NICU）对86例患有凝血病的单纯性创伤性脑损伤患者进行治疗。他们的创伤登记数据包括死亡率、rFVIIa治疗前后的凝血参数。采用双尾配对t检验来确定凝血参数和其他主要临床参数的显著变化。
27例患者组成低剂量rFVIIa（20μg/kg）组。对照组有59例匹配良好的受试者。入院时，两组患者的年龄、血压、格拉斯哥昏迷量表评分、血红蛋白、血小板和国际标准化比值相似。治疗后，rFVIIa治疗患者的INR低于传统治疗组（1.1±0.2对1.2±0.2，P<0.01），且rFVIIa组下降更多（0.3±0.2对0.1±0.4，P = 0.05）。两组之间的死亡率或住院时间无显著差异。未发生后续血栓栓塞事件。
小剂量rFVIIa的应用可有效降低INR值，改善患者的凝血状态。在治疗过程中，未发生重大不良事件。
