Aronstam A, Wassef M, Hamad Z, McLellan D S
Clin Lab Haematol. 1981;3(2):107-12. doi: 10.1111/j.1365-2257.1981.tb01319.x.
Three hundred and thirty-nine consecutive bleeds into the knees, elbows and ankles of severe haemophiliacs were graded I if more than 50% of normal movement was present, and graded 2 if less than 50% of normal movement was present. Nursing staff then administered randomly allocated doses of 7,14 or 28 units of factor VIII per kg. Medical staff unaware of initial doses assessed progress thereafter at 12-hourly intervals. Grade I bleeds into "normal" joints showed no difference in response to the three dosage regimes, but grade 2 bleeds did worse on low doses. There was no significant difference in the response to each dose of bleeds into restricted and into target joints. However, when a restricted joint became a target joint as well, both grade I and grade 2 bleeds did badly on low doses. The target joint as well, both grade I and grade 2 bleeds did badly on low doses. The percentage of patients with bleeds into these joints whose range of movement had not returned to baseline 48 h after receiving a low dose of factor VIII was significantly higher than those who had received the higher doses.
对339例重度血友病患者膝关节、肘关节和踝关节连续出血的情况进行分级：若关节活动度超过正常的50%，则为1级；若低于正常的50%，则为2级。护理人员随后随机给予每千克体重7、14或28单位的凝血因子VIII剂量。不知情初始剂量的医务人员此后每隔12小时评估病情进展。“正常”关节的1级出血对三种剂量方案的反应无差异，但2级出血在低剂量时情况较差。限制关节和目标关节出血对每种剂量的反应无显著差异。然而，当一个限制关节同时也成为目标关节时，1级和2级出血在低剂量时情况都很糟。同样，目标关节的1级和2级出血在低剂量时情况也很糟。接受低剂量凝血因子VIII后48小时，这些关节出血且活动度未恢复至基线的患者百分比显著高于接受高剂量的患者。
