Goldsmith R, Chan A K, Paes B A, Bhatt M D
Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, McMaster University, Hamilton, ON, Canada.
Division of Neonatology, McMaster Children's Hospital, McMaster University, Hamilton, ON, Canada.
J Perinatol. 2015 Oct;35(10):852-4. doi: 10.1038/jp.2015.84. Epub 2015 Jul 16.
The objective of our study was to determine the feasibility and safety of enoxaparin whole milligram dosing in premature and term neonates, and to assess response to treatment.
Retrospective study of neonates with thrombosis treated between January 2008 and December 2014.
Nineteen premature and 21 term neonates were treated with whole milligram doses of enoxaparin. The mean starting and therapeutic enoxaparin doses were 1.72±0.17 and 1.86±0.17 mg kg(-1), respectively. Twenty-five (64%) reached therapeutic antifactor Xa (anti-Xa) levels with the starting dose, whereas 14 (36%) required dose adjustments. One neonate reached a supratherapeutic anti-Xa level (>1.0 IU ml(-1)) in the loading phase. No bleeding episodes occurred. The mean treatment duration was 12 weeks. Among 34 (85%) evaluable patients, 23 (68%) had a complete response, 9 (26%) partial and 2 (6%) had a stable thrombotic state.
Whole milligram dosing of enoxaparin for thrombosis is feasible, safe and effective in premature and term neonates.
我们研究的目的是确定依诺肝素全毫克剂量用于早产和足月新生儿的可行性与安全性，并评估治疗反应。
对2008年1月至2014年12月期间接受血栓治疗的新生儿进行回顾性研究。
19例早产儿和21例足月儿接受了依诺肝素全毫克剂量治疗。依诺肝素的平均起始剂量和治疗剂量分别为1.72±0.17和1.86±0.17mg/kg(-1)。25例（64%）起始剂量时达到治疗性抗Xa因子（抗-Xa）水平，而14例（36%）需要调整剂量。1例新生儿在负荷期达到超治疗性抗-Xa水平（>1.0IU/ml(-1)）。未发生出血事件。平均治疗持续时间为12周。在34例（85%）可评估患者中，23例（68%）完全缓解，9例（26%）部分缓解，2例（6%）血栓状态稳定。
依诺肝素全毫克剂量用于治疗早产和足月新生儿血栓可行、安全且有效。
