Lusher J M, Shapiro S S, Palascak J E, Rao A V, Levine P H, Blatt P M
N Engl J Med. 1980 Aug 21;303(8):421-5. doi: 10.1056/NEJM198008213030803.
The therapeutic efficacy of prothrombin-complex concentrates in patients with hemophilia and inhibitors (antibodies) to factor VIII has been increasingly debated. We therefore entered 51 hemophiliacs with factor VIII inhibitors into a double-blind randomized crossover study to compare two commercial prothrombin-complex concentrates (Konyne and Proplex) and an albumin placebo. Acute hemarthrosis of the elbow, knee, or ankle was treated with a single dose of a test preparation and assessed six hours later with objective and subjective criteria. In all measurements the concentrates were significantly more effective than the placebo. The data indicate that although prothrombin-complex concentrates, when used in a single dose, are only partially effective in the treatment of joint hemorrhage in hemophiliacs with inhibitors, their continued use for acute hemarthrosis is justified in the absence of any other effective and readily available therapy for this disorder.
凝血酶原复合物浓缩剂对血友病患者及抗凝血因子VIII抗体（抑制剂）患者的治疗效果一直存在越来越多的争议。因此，我们让51名患有抗凝血因子VIII抗体的血友病患者参与了一项双盲随机交叉研究，以比较两种市售凝血酶原复合物浓缩剂（科尼因和普罗普莱士）及一种白蛋白安慰剂。对肘、膝或踝关节的急性关节积血用单剂量的一种试验制剂进行治疗，并在6小时后采用客观和主观标准进行评估。在所有测量中，浓缩剂都比安慰剂显著有效。数据表明，尽管凝血酶原复合物浓缩剂单剂量使用时，对患有抑制剂的血友病患者关节出血的治疗仅部分有效，但在没有其他有效且容易获得的针对该病症的治疗方法时，持续使用其治疗急性关节积血是合理的。
