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延长蝮蛇血凝酶给药时间可导致血液系统疾病患者出现低纤维蛋白原血症:11例患者的临床分析

Prolonged Hemocoagulase Agkistrodon Halys Pallas Administration Induces Hypofibrinogenemia in Patients with Hematological Disorders: A Clinical Analysis of 11 Patients.

作者信息

Linglong Xu, Dijiong Wu

机构信息

1First Medical School, Zhejiang Chinese Medical University, Hangzhou, 310053 China.

2Department of Hematology, Taizhou Central Hospital, Taizhou, 318000 China.

出版信息

Indian J Hematol Blood Transfus. 2018 Apr;34(2):322-327. doi: 10.1007/s12288-017-0859-z. Epub 2017 Aug 14.

Abstract

Hemocoagulase Agkistrodon Halys Pallas, a well-established hemostatic agent used in China, has widespread applications in various conditions of bleeding and hemorrhages. Although it presents a low risk of vascular thrombosis, the agent can be easily tolerated and does not show any harmful effects, except allergy. However, long-term use of hemocoagulase may induce hypofibrinogenemia in some patients. Herein, we report 11 patients of prolonged administration of hemocoagulase Agkistrodon, with particular attention to the dynamic changes in their coagulation functions. A marked decline in the level of fibrinogen was observed in patients suffering from hematological disorders, following an extended exposure to hemocoagulase. Nevertheless, the low fibrinogen levels increased after withdrawal of the agent. Since the D-dimer level did not show any significant increase, hemocoagulase inducing lower fibrinogen may be considered to be a process of primary fibrinolysis. In conclusion, we suggested that hemocoagulase must be cautiously used in patients with hematological disorders, because of the potential risk of fibrinolysis; and the coagulation functions should be carefully evaluated during the administration of hemocoagulase.

摘要

尖吻蝮蛇血凝酶是中国一种成熟的止血剂,在各种出血和大出血情况中有着广泛应用。尽管它引发血管血栓形成的风险较低,容易耐受,除过敏外无任何有害影响。然而,长期使用尖吻蝮蛇血凝酶可能会使一些患者出现低纤维蛋白原血症。在此,我们报告11例长期使用尖吻蝮蛇血凝酶的患者,特别关注其凝血功能的动态变化。血液系统疾病患者在长时间使用尖吻蝮蛇血凝酶后,观察到纤维蛋白原水平显著下降。不过,停药后低纤维蛋白原水平有所上升。由于D - 二聚体水平未出现任何显著升高,因此可认为尖吻蝮蛇血凝酶诱导纤维蛋白原降低可能是原发性纤溶过程。总之,我们建议血液系统疾病患者应谨慎使用尖吻蝮蛇血凝酶,因为存在纤溶的潜在风险;并且在使用尖吻蝮蛇血凝酶期间应仔细评估凝血功能。

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