Olson Nicholas J, Ornstein Deborah L
Arch Pathol Lab Med. 2017 Dec;141(12):1728-1731. doi: 10.5858/arpa.2016-0445-RS.
Historically, inhibitors to coagulation factor V (FV) most often have developed in patients treated with bovine thrombin, a topical hemostatic agent used during surgical procedures. With the advent of newer hemostatic agents, and the concurrent diminished use of bovine thrombin, the incidence of FV inhibitors has fallen. Nevertheless, FV inhibitors are occasionally seen on an idiopathic basis as well as in association with medications, malignancies, autoimmune disorders, pregnancy, and infections. Factor V inhibitors may present with life-threatening bleeding or thrombosis, or they may be discovered incidentally as a coagulation screening test abnormality. Management of patients with FV inhibitors is challenging and consists of control of bleeding and eradication of the inhibitor. In this short overview we review the role of platelet and plasma FV in hemostasis and discuss the unique characteristics, clinical features, diagnosis, treatment, and prognosis associated with FV inhibitors.
从历史上看，凝血因子V（FV）抑制剂最常出现在接受牛凝血酶治疗的患者中，牛凝血酶是一种在外科手术中使用的局部止血剂。随着新型止血剂的出现以及牛凝血酶使用量的同时减少，FV抑制剂的发病率有所下降。然而，FV抑制剂偶尔也会在特发性情况下出现，以及与药物、恶性肿瘤、自身免疫性疾病、妊娠和感染相关。FV抑制剂可能表现为危及生命的出血或血栓形成，也可能在凝血筛查试验异常时偶然被发现。FV抑制剂患者的管理具有挑战性，包括控制出血和消除抑制剂。在这篇简短的综述中，我们回顾了血小板和血浆FV在止血中的作用，并讨论了与FV抑制剂相关的独特特征、临床特征、诊断、治疗和预后。
