Janson P A, Jubelirer S J, Weinstein M J, Deykin D
N Engl J Med. 1980 Dec 4;303(23):1318-22. doi: 10.1056/NEJM198012043032302.
We gave cryoprecipitate to six patients with uremia and bleeding times prolonged to more than 15 minutes. After the infusion, all patients had shortened bleeding times; the times of five became normal. In four patients control of major bleeding episodes was attained, and five underwent major surgical or invasive procedures, with good hemostasis. After infusion the time before the nadir of the bleeding time was reached was between one and 12 hours. The bleeding time returned to pretreatment levels by 24 hours after infusion in five patients, and by 36 hours in the other patient. Platelet-aggregation studies before infusion gave normal results in three patients and abnormal results in three. There wasno change after infusion. Before infusion, levels of Factor VIII coagulant activity and Factor VIII von Willebrand activity were normal, Factor VIII-related antigen was increased, and crossed immunoelectrophoresis of Factor VIII-related antigen was normal. Our findings suggest that cryoprecipitate can temporarily correct the bleeding tendency in patients with uremia.
我们给6名尿毒症且出血时间延长至15分钟以上的患者输注了冷沉淀。输注后，所有患者的出血时间均缩短；其中5名患者的出血时间恢复正常。4名患者的严重出血发作得到控制，5名患者接受了大型外科手术或侵入性操作，止血效果良好。输注后，达到出血时间最低点之前的时间为1至12小时。5名患者在输注后24小时出血时间恢复到预处理水平，另一名患者在36小时恢复到预处理水平。输注前血小板聚集研究结果显示，3名患者正常，3名患者异常。输注后无变化。输注前，凝血因子VIII的凝血活性和血管性血友病因子VIII活性水平正常，凝血因子VIII相关抗原增加，凝血因子VIII相关抗原的交叉免疫电泳正常。我们的研究结果表明，冷沉淀可暂时纠正尿毒症患者的出血倾向。
