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贝米肝素用于新生儿血栓形成:治疗剂量与安全性

Bemiparin in neonatal thrombosis: therapeutic dosing and safety.

作者信息

Sanchez-Holgado Maria, Sampedro Mercedes, Zozaya Carlos, Permuy Romero Celia, Alvarez-Garcia Patricia, La Banda-Montalvo Leticia, Nieto Clara, Pellicer Adelina

机构信息

Department of Neonatology. La Paz University Hospital, Madrid, Spain.

出版信息

J Perinatol. 2025 Feb;45(2):224-228. doi: 10.1038/s41372-024-02200-1. Epub 2024 Dec 16.

DOI:10.1038/s41372-024-02200-1
PMID:39681735
Abstract

OBJECTIVE

To evaluate the therapeutic dose and safety of bemiparin in neonatal thrombosis treatment.

STUDY DESIGN

A retrospective review was conducted on infants treated with bemiparin between 2018 and 2023 at a tertiary hospital.

RESULTS

72 neonates with a mean gestational age of 37 weeks were included. Twenty were preterm, with a median gestational age of 33.5 weeks and a median birth weight of 1847.5 grams. The mean (SD) initial and therapeutic bemiparin doses were 170.5 (31) and 200 (37.2) IU/kg/day, respectively. Only 32% of patients reached the therapeutic target range (TTR) with the initial dose. Preterm infants required higher doses to reach TTR (215 vs 194.7 IU/kg/day, p = 0.05). Adverse events were minimal (1.4%) and unrelated to the starting dose or prematurity.

CONCLUSION

Bemiparin appears to be a potential therapeutic option for anticoagulation in neonates; however, targeted anti-Xa levels were rarely achieved with the initial dose and most patients required uptitration.

摘要

目的

评估贝米肝素治疗新生儿血栓形成的治疗剂量和安全性。

研究设计

对2018年至2023年在一家三级医院接受贝米肝素治疗的婴儿进行回顾性研究。

结果

纳入72例平均胎龄为37周的新生儿。其中20例为早产儿,中位胎龄为33.5周,中位出生体重为1847.5克。贝米肝素的平均(标准差)初始剂量和治疗剂量分别为170.5(31)和200(37.2)IU/kg/天。只有32%的患者初始剂量达到治疗目标范围(TTR)。早产儿达到TTR需要更高的剂量(215比194.7 IU/kg/天,p = 0.05)。不良事件极少(1.4%),且与起始剂量或早产无关。

结论

贝米肝素似乎是新生儿抗凝治疗的一种潜在选择;然而,初始剂量很少能达到目标抗Xa水平,大多数患者需要增加剂量。

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Bemiparin in neonatal thrombosis: therapeutic dosing and safety.贝米肝素用于新生儿血栓形成:治疗剂量与安全性
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本文引用的文献

1
The Hemostatic System in Newborns and the Risk of Neonatal Thrombosis.新生儿止血系统与新生儿血栓形成风险。
Int J Mol Sci. 2023 Sep 8;24(18):13864. doi: 10.3390/ijms241813864.
2
Optimal dosing of bemiparin for deep vein thrombosis treatment in children: a retrospective study.儿童深静脉血栓形成治疗中贝米肝素的最佳剂量:一项回顾性研究。
Blood Coagul Fibrinolysis. 2021 Oct 1;32(7):526-527. doi: 10.1097/MBC.0000000000001066.
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How to use low-molecular-weight heparin to treat neonatal thrombosis in clinical practice.在临床实践中如何使用低分子量肝素治疗新生儿血栓形成。
Blood Coagul Fibrinolysis. 2021 Dec 1;32(8):531-538. doi: 10.1097/MBC.0000000000001052.
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Treatment of venous thromboembolism in pediatric patients.儿科患者的静脉血栓栓塞症治疗。
Blood. 2020 Jan 30;135(5):335-343. doi: 10.1182/blood.2019001847.
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Risk Factors for Neonatal Venous and Arterial Thromboembolism in the Neonatal Intensive Care Unit-A Case Control Study.新生儿重症监护病房新生儿动静脉血栓栓塞的危险因素:病例对照研究。
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Comparison of Once-Daily Bemiparin with Twice-Daily Enoxaparin for Acute Deep Vein Thrombosis: A Multicenter, Open-Label, Randomized Controlled Trial.每日一次贝米肝素与每日两次依诺肝素治疗急性深静脉血栓形成的比较:一项多中心、开放标签、随机对照试验。
Clin Drug Investig. 2018 Feb;38(2):181-189. doi: 10.1007/s40261-017-0600-6.
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Antithrombotic treatment in neonates and children.新生儿和儿童的抗血栓治疗。
Minerva Pediatr. 2018 Feb;70(1):67-78. doi: 10.23736/S0026-4946.17.05131-3. Epub 2017 Nov 21.
8
Neonatal Venous Thromboembolism.新生儿静脉血栓栓塞症
Front Pediatr. 2017 Jun 6;5:136. doi: 10.3389/fped.2017.00136. eCollection 2017.
9
Anticoagulation therapy in neonates, children and adolescents.新生儿、儿童和青少年的抗凝治疗。
Blood Cells Mol Dis. 2017 Sep;67:41-47. doi: 10.1016/j.bcmd.2017.05.008. Epub 2017 May 13.
10
Developmental Hemostasis and Management of Central Venous Catheter Thrombosis in Neonates.新生儿发育性止血与中心静脉导管血栓形成的管理
Semin Thromb Hemost. 2016 Oct;42(7):752-759. doi: 10.1055/s-0036-1592299. Epub 2016 Sep 16.