Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
Haematologica. 2020 May;105(5):1201-1205. doi: 10.3324/haematol.2020.250720. Epub 2020 Mar 26.
Tranexamic acid (TXA) is an anti-fibrinolytic agent that acts by inhibiting plasminogen activation and fibrinolysis. Although its first clinical use dates back more than 50 years, this hemostatic agent is still the object of intense clinical and developmental research. In particular, renewed interest in TXA has arisen following evidence that it has a beneficial effect in reducing blood loss in a variety of medical and surgical conditions at increased risk of bleeding. Given this characteristic, TXA is currently considered a mainstay of Patient Blood Management programs aimed at reducing patients' exposure to allogeneic blood transfusion. Importantly, recent large randomized controlled trials have consistently documented that the use of TXA confers a survival advantage in a number of globally critical clinical conditions associated with acute bleeding, including traumatic injury and post-partum hemorrhage, without increasing the thromboembolic risk.
氨甲环酸（TXA）是一种抗纤维蛋白溶解剂，通过抑制纤溶酶原激活和纤维蛋白溶解起作用。尽管其首次临床应用可以追溯到 50 多年前，但这种止血剂仍然是临床和开发研究的重点。特别是，在有证据表明它在多种增加出血风险的医疗和手术情况下具有减少失血的有益作用后，对 TXA 的兴趣重新燃起。鉴于这一特点，TXA 目前被认为是患者血液管理计划的主要手段，旨在减少患者接触异体输血。重要的是，最近的大型随机对照试验一致证明，在许多与急性出血相关的全球危急临床情况下，包括创伤性损伤和产后出血，使用 TXA 可带来生存优势，而不会增加血栓栓塞风险。
