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使用直接凝血酶抑制剂干预以循环血栓形成特征的COVID-19相关高凝状态。

Intervention in COVID-19 linked hypercoaguable states characterized by circuit thrombosis utilizing a direct thrombin inhibitor.

作者信息

Seshadri Madhav, Ahamed Jasimuddin, Laurence Jeffrey

机构信息

Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY, USA.

Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.

出版信息

Thromb Update. 2020 Dec;1:100009. doi: 10.1016/j.tru.2020.100009. Epub 2020 Sep 8.

DOI:10.1016/j.tru.2020.100009
PMID:38620488
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7476895/
Abstract

•Circuit thrombosis complicates CRRT in COVID-19 despite standard heparin-based anticoagulation regimens.•5 cases of CRRT thrombosis despite heparin-based anticoagulation resolved using a direct thrombin inhibitor, argatroban.•Changes in fibrinogen levels better reflected response to anticoagulation than did changes in D-dimer levels.•High fibrinogen levels and decreased anti-thrombin III activity may relate to argatroban superiority in these cases.

摘要

•尽管采用了基于肝素的标准抗凝方案，但回路血栓形成仍是新冠肺炎患者连续性肾脏替代治疗（CRRT）的并发症。

•5例接受基于肝素抗凝治疗的CRRT血栓形成患者使用直接凝血酶抑制剂阿加曲班后血栓溶解。

•纤维蛋白原水平的变化比D-二聚体水平的变化更能反映抗凝治疗的反应。

•高纤维蛋白原水平和抗凝血酶III活性降低可能与这些病例中阿加曲班的优势有关。

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Anticoagulation with argatroban in patients with acute antithrombin deficiency in severe COVID-19.在重症新型冠状病毒肺炎急性抗凝血酶缺乏患者中使用阿加曲班进行抗凝治疗。
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